Primary adrenal melanoma (PAM) is a rare malignant tumor, with few reported cases in the published literature and often correlated with high mortality rates. This condition usually has an unclear clinical presentation and must have its differential diagnosis regarding metastatic processes from malignant melanoma and pigmented pheochromocytoma. In this article, we report a case of a 49-year-old male diagnosed with PAM, alongside with its progress and discussions about the diagnostic criteria established, willing to expand and disseminate knowledge and awareness about PAM [1].