Melanoma is prone to bone metastasis, and the spine is the site of metastasis. However, melanoma with clinical symptoms of bone metastases as the first symptom is rare. We treated 1 patient with malignant melanoma with symptoms of bone metastases as the first symptom. The patient had visited the orthopedic clinic in the external hospital many times before coming to our hospital for treatment, but they were not diagnosed. The patient''s diagnosis and treatment process is now reported.