Background: Melanocytic nevus is a rare occurrence in the tarsal conjunctiva and only 7 well-described cases have been reported previously in the English literature.Case Report: The medical records of 4 patients with tarsal conjunctival melanocytic nevus were reviewed, together with the relevant literature. All patients (3 women and 1 man; age range: 17 - 40 years) had been referred with a suspicion of melanoma. There was one tarsal nevus in the lower eyelid in 3 patients and 2 nevi in the upper eyelid in 1 patient. All lesions were darkly pigmented with irregular borders and were associated with a history of a recent growth in size. An intralesional cyst was present in 1 nevus only. Af-ter surgical excision, no recurrence or complication occurred during the follow-up period (range: 7 - 48 months).Conclusion: Tarsal melanocytic nevus has been de-scribed in detail in 11 cases, including these 4 cases, in the English literature. The lesion arose from the lower eyelid in all cases except one. Tarsal melano-cytic nevi may frequently display clinical features suggesting melanoma, such as advanced patient age, recent growth, dark and irregular pigmentation, nodu-larity, hypervascularity, and the absence of an intral-esional cyst. After total excision, nevus recurrence or malignant trans-formation has not been reported.Keywords: Conjunctiva, conjunctival nevus, mela-nocytic nevus, tarsal plae