The histological diagnosis of pediatric melanocytic tumors is challenging, as benign nevi often resemble aggressive tumors. Accurate diagnosis is crucial for the early detection of rare pediatric melanomas. Recent advancements have established a classification based on genetic backgrounds. This classification distinguishes between rarer subtypes and includes groups such as conventional melanomas, Spitz tumors, and melanomas arising from congenital melanocytic nevi. While the most common group, Spitz tumors, generally has a favorable prognosis, conventional melanomas and especially those arising from congenital nevi may exhibit an aggressive course similar to that of adult melanoma.