A 36-year-old man presented with trouble speaking and bilateral progressive hearing loss. MR imaging and histopathologic results revealed a posterior fossa melanotic ependymoma. Pial surfaces appeared hyperin-tense on T1-weighted images and hypointense on T2-weighted images. Histopathologic examination revealed that tumor cells and interstitial spaces had abundant melanin accumulation. There was no evidence of hemosiderin in tumor cells and in interstitial spaces. Pial melanin accumulation secondary to a posterior fossa melanotic ependymoma explained our MR findings. © American Society of Neuroradiology.