Childhood malignant melanoma is rare and difficult to diagnose. This is a case report of a 7-year-old with a lesion originally diagnosed as a pyogenic granuloma, which was a metastasizing malignant melanoma. This report distinguishes between the histology of melanoma and that of Spitz naevus and highlights the need to be aware of this condition, as its management and prognosis are similar to that of malignant melanoma in the adult population.