Purpose: We review the results of treatment of small to medium-sized choroidal malignant melanomas after high-dose-rate brachytherapy with a strontium-90 applicator. • Methods: The applicator is positioned against the sclera using an afterloading technique. Brachytherapy is completed in a single session lasting 2–4 h with the patient under local anaesthesia. From September 1983 until March 1995, 46 eyes were treated in this way. Most tumours were 7–11 mm in diameter (range from 4.5–15 mm) with a mean height of approximately 3 mm (range from 1.5–7 mm). Follow-up ranged from 6 months to 12 years (mean 49 months). • Results: Thirty of the 46 eyes had at the final evaluation a non-evolutive scar (20 of these after a single application, the others with some additional treatment). In 13 eyes the tumours were in involution but their complete destruction was not yet certain, and 3 eyes were enucleated for local recurrence. Three patients developed systemic metastases. No radiogenic complications were noticed. • Conclusion: Strontium-90 brachytherapy is a valuable and safe treatment technique for small to medium-sized choroidal malignant melanomas. In addition the use of a strontium-90 applicator is inexpensive thanks to this element′s long half-life and the short application time.