Although most melanocytic lesions can be diagnosed by histopathologists as benign or malignant with high confidence, a subset of morphologically ambiguous lesions does exist and still represents a significant problem for pathologists. These lesions have been defined as MELTUMP, i.e. melanocytic tumors of uncertain malignant potential. MELTUMP could be considered as a large cauldron in which melanocytic lesions with equivocal morphologic features fall into, including most benign lesions and a minority of melanomas, unfortunately recognizable only a posteriori for their unfavorable outcome. As a consequence of the lack of uniformity in the biologic behavior of melanocytic lesions belonging to the heterogeneous subset of MELTUMP, confusion and lack of agreement in the management of these difficult lesions is increasingly growing up. As most MELTUMP have a favorable prognosis we recommend a conservative approach, avoiding over treatment for this group of lesions.