A pigmented optic nerve head lesion was detected on fundoscopy in a 57 years old female who presented with bad distance visual acuity. Based on clinical findings and ancillary studies, our diagnosis was (presumed) optic disc melanocytoma, and periodic examinations were scheduled. One year later the tumour size did not show any change. Patients with melanocytoma should be examined at regular intervals, serial fundus photographs are useful for monitoring growth and suspecting malignant transformation.