Pediatric melanoma is defined as melanoma diagnosed between birth and 18 years of age. It is rare, constituting approximately 1% of all pediatric cancers, with a global incidence of 2–5 new cases per million people annually. Pediatric melanoma often lacks the typical clinical features of pigmented melanoma, and a considerable proportion of cases may be hypomelanotic to amelanotic and raised, clinically mimicking pyogenic granuloma, nonpigmented Spitz nevus, and atypical Spitz tumors. At dermatoscopy, a multicomponent pattern is most frequently retrieved in pigmented melanoma, while a polymorphous vascular pattern, composed by a combination of dotted vessels and linear–irregular vessels, often associated with remnants of pigmentation, is usually detected in amelanotic melanoma. Milky red globules, characterized by a reddish-whitish color, irregular size, and blurred borders, are less frequent features, highly specific for nodular amelanotic melanoma.