Although there are effective treatments for primary uveal melanoma, the prognosis for metastatic disease is poor. There is no curative therapy for metastatic uveal melanoma. Options include systemic therapies, such as tebentafusp or other immunotherapy, or liver-directed therapies, such as surgical resection, radiofrequency ablation, or hepatic arterial approaches. Tebentafusp is a first-in-class immune mobilizing monoclonal T cell receptor against cancer (ImmTAC) and is the first systemic therapy to demonstrate a survival benefit in metastatic uveal melanoma in a randomized trial.