We feel it prudent to sound a note of caution about the use of levodopa in patients with known melanomas or with pigmented lesions. Levodopa was administered to three of our patients with Parkinson9s disease and known melanomas or pigmented lesions. One had had a “benign” pigmented nevus for 20 years that increased in size during levodopa therapy. Excisional biopsy of the lesion revealed it to be a malignant melanoma. Levodopa was discontinued and there has been no evidence of recurrence. The second patient had had a malignant melanoma excised one year before initiation of levodopa therapy. Two months after levodopa was begun, signs of an intracerebral tumor, presumably a melanoma, developed, and the patient died. The third patient had had a melanoma excised more than seven years (88 months) before initiation of levodopa therapy. He remains well two years later. In two additional cases in the literature, a temporal association was found between initiation of levodopa therapy and growth of melanoma.