Purpose of Review <p>This review presents an update on surgical strategies for the diagnosis, characterization, and management of all major subtypes of ocular melanoma, including conjunctival, iris, ciliary body, and choroidal tumors.</p> Recent Findings <p>Advances in fine-needle aspiration, vitrectomy-based, and forceps biopsy techniques have enhanced diagnostic accuracy, enabled molecular profiling, and minimized procedural morbidity. Plaque brachytherapy, proton beam irradiation, and stereotactic radiotherapy remain foundational treatment modalities, and are increasingly complemented by globe-preserving resections and adjunctive cryotherapy to improve local tumor control. More advanced disease can require exenteration. For metastatic disease, the therapeutic landscape is expanding with novel targeted agents and immunotherapies. Integration of molecular prognostic tools now informs individualized risk stratification and surveillance strategies.</p> Summary <p>Surgery continues to occupy a central role in the care of ocular melanoma, with modern practice emphasizing precision diagnostics, minimally invasive interventions, and multidisciplinary collaboration to optimize preserving vision, the eye, and life.</p>