Vaginal mucosal melanoma is rare and insidious. A 74-year-old woman underwent 18 F-FDG and 68 Ga-FAPI-04 PET/CT for vaginal masses. The masses showed significant uptake of 68 Ga-FAPI compared with 18 F-FDG. In our case, this indicates the potential value of 68 Ga-FAPI-04 PET/CT in the diagnosis of mucosal melanoma.