Objective The aim of this study was to investigate the association between clinical and pathological characteris- tics of primary oral mucosal malignant melanoma and the prognosis of this disease.Methods Clinical and pathological characters of 73 cases primary oral mucosal malignant melanoma were investigated. The association between risk factors, such as black macule, lymph node metastases, invasive depth, clinic stages, pathologic types, and prognosis was analyzed using Kaplan-Meier survival analysis and Log rank test.Results The age of the patients ranged from 24 to 80 years (Median age, 50). Among the patients, 43 were males and 30 were females. The most common locations of the tumorwere palate and gingiva. The clinic stages of these patients were as the following: StageⅠ(46/73), StageⅡ(24/73), StageⅢ(3/73). The most common pathological type was nodular (44/73), followed by lentiginose malignant melanoma (15/73) and superficial spreading (1/73). According to the configuration of tumor cells, the most common typewas the mixed cell type (37/73), followed bythe epitheloid cell type (27/73) and the spindle cell type (9/73). Among the 73 patients, 43 were followed up, the 3-year and 5-year survival rates were 19.86% and 11.91% respec- tively. Black macule, lymph node metastases, invasive depth, clinic stages, pathologic types and therapeutic methods were signifi- cantly associated with the prognosis (P<0.05).Conclusion The prognosis of the primary oral mucosal malignant melanoma is as- sociated with black macule, lymph node metastases, invasive depth, clinic stages, pathologic types, and therapeutic methods.