Primary malignant melanoma of central nervous system accounts for approximately 1% of all melanomas. Primary spinal melanomas are even more unusual. The clinico-radiological features of primary spinal melanoma are complex and non-specific, resulting in a high misdiagnosis rate. Here, primary cervico-thoracic spinal melanoma is presented in a 53-year-old woman which mimicked a hematoma on magnetic resonance imaging and an arteriovenous malformation intraoperatively. Histopathology and immunohistochemistry confirmed the diagnosis of malignant melanoma.