In the six cases we have presented, a hematoma under the retinal pigment epithelium was the basis of a pigmented lesion at the posterior pole of the eye, leading to the clinical impression of malignant melanoma and to subsequent enucleation of the eye. The clinical observation of a rapidly expanding, relatively flat, pigmented lesion at the posterior pole should suggest a hemorrhagic rather than a neoplastic lesion. In these cases, careful clinical study of both eyes, with repeated periodic ophthalmoscopic examinations, should be done before a definite diagnosis can be made with reasonable certainty.