目的　探讨直肠肛管恶性黑色素瘤的临床表现、诊断、治疗及预后。方法　回顾性分析了 1981～ 1996年我科诊治的直肠肛管恶性黑色素瘤 6例 ,并进行随访。结果　 6例患者肿块位于齿状线附近 ,肉眼观为紫黑色或褐色 ,均行手术治疗 ,其中 2例行Mile’s术 ,2例行后盆腔清扫术 ,1例行经肛门肿块局部扩大切除术 ,1例行剖腹探查术 ,所有患者手术时均已有淋巴结或肝脏转移。 6例患者于确诊后 5～ 2 3个月死亡 ,平均存活 14 .7个月。结论　直肠肛管恶性黑色素瘤恶性度极高 ,死亡率高 ,较早发生淋巴和血行转移 ,宜采用根治手术辅以化疗及生物治疗的综合性治疗 Objective To investigate the clinical manifestations, diagnosis, treatment and prognosis of rectal malignant melanoma. Methods Retrospective analysis of 6 cases of rectal canal malignant melanoma diagnosed and treated in our department from 1981 to 1996 was followed up. Results The lumps of 6 patients were located near the dentate line. The macroscopic appearance was purple-black or brown. All patients underwent surgical treatment. Among them, 2 cases underwent Mile’s surgery, 2 cases underwent pelvic dissection, 1 case underwent local enlargement resection via anal mass, A routine laparotomy, all patients had lymph node metastases or liver metastases at the time of surgery. Six patients died within 5 to 23 months after diagnosis, with an average survival of 14.7 months. Conclusions Malignant rectal malignant melanoma is extremely malignant and has a high mortality rate. Early lymphatic and hematogenous metastases should be treated by radical surgery combined with chemotherapy and biotherapy