Uveal melanoma is the most common primary eye cancer, yet its molecular pathogenesis is poorly understood. In this study, we investigated the immunohistochemical expression of proteins in the Rb and p53 tumor suppressor pathways in 33 uveal melanomas from enucleated eyes. Strong nuclear staining for Rb was present in most tumors. However, a few cases displayed weak nuclear staining and strong cytoplasmic staining (possibly indicating Rb mutation), and this aberrant staining correlated strongly with failed radiotherapy or thermotherapy before enucleation. Staining for cyclin D1 was positive in most tumors and was associated with advanced age and larger tumor size, which are both poor prognostic factors. Generally, immunostaining for p53 was weak (suggesting a lack of p53 mutations), although p53 positivity correlated strongly with staining for phosphorylated Rb, supporting the notion that inappropriate phosphorylation of Rb can induce p53. Strong immunostaining for MDM2, which can functionally block p53 activity, was observed in most tumors and correlated significantly with female sex. Strong cytoplasmic staining was observed for Bcl2, which can inhibit both p53-dependent and -independent apoptosis. We conclude that Rb and p53 are mutated infrequently in uveal melanoma , but their respective pathways may be functionally inactivated. Uveal melanoma is the most common primary malignancy of the eye, yet little is known about its molecular pathogenesis. In contrast to cutaneous melanoma in which significant advances have been made in understanding the molecular etiology, 1 no genes or tumor suppressor pathways have been convincingly linked to uveal melanoma. In addition, most evidence suggests that uveal melanoma differs etiologically from its cutaneous counterpart. Cytogenetic changes commonly found in cutaneous melanoma include loss of 1p, 6q, and 10q, and gain of chromosome 7, 1 whereas the most common changes in uveal melanoma are loss of 3p and 6q, and gain of 6p and 8q. [2][3][4] In addition, the p16/INK4a tumor suppressor locus on chromosome 9p21 is frequently deleted in cutaneous melanoma, 1 but it is rarely altered in uveal melanoma. [5][6][7][8] This void in our understanding of uveal melanoma is complicated by the fact that this tumor is rarely familial and is not amenable to genetic linkage analysis. Therefore, one approach to examining the molecular pathogenesis of uveal melanoma is to study the Rb and p53 tumor suppressor pathways, both of which are commonly disrupted in cancer. 9,10