Background: Conjunctival melanoses are a common clinical finding of flat granular melanoticpigmentation of the conjunctival epithelium. Differential diagnosis of these lesions is difficult andthere is much confusion in the literature regarding their classification. Objective: To update the readers’ knowledge about conjunctival melanosis and its clinicopathologicclassification. Method: The author searched electronic databases for primary studies (MEDLINE, EMBASE,and CINAHL) and systematic reviews (PubMed) from the early 1960 when these lesions weredescribed until the end of December 2012. Selection Criteria: English-language systematic reviews; randomized, controlled trials; andquasi-randomized, controlled trials for conjunctival melanosis. Data collection and analysis: Abstracts were screened and data were extracted and reviewed bythe author. Result: The conjunctival melanoses are a group of diseases characterized by flat granular melaninpigmentationof conjunctival epithelium. Because differential diagnosis of these lesions is difficult,there is much confusion in the literature regarding their classification. Conclusion: Benign, melanosis should be divided based on clinical findings into complexionassociatedmelanosis, secondary melanosis, ephelis, and primary acquired melanosis withoutatypia. Primary acquired melanosis with atypia is more likely to evolve into a malignantmelanoma.