Uveal melanoma (UM) is an ocular tumor with a dismal prognosis. It is the most frequent primary intraocular tumor in adults. The primary goal of treatment for uveal melanomas is to prevent metastasis. Despite outstanding advances in the diagnosis and treatment of primary UM, nearly 50% of patients develop metastases via hematogenous dissemination. Estimation of prognosis for patients with UM can be achieved by detecting genetic alterations or epigenetic changes in the tumor tissues. However, these techniques are not always available. The clinicopathological characteristics with limited accuracy are widely used instead to predict metastatic potential. Identifying novel markers with prognostic potential can help refine the prognosis of UM patients. As we know, no existing therapy has a significantly better impact on preventing metastasis. Based on published theories, the key role is existing micrometastasis before therapy starts. Researchers are focusing on developing adjuvant systemic therapy for metastatic UM. Getting to know the cause of metastatic uveal melanoma is crucial in it.