The non-melanoma skin cancer is the most frequent in Brazil, affecting mainly people over 40 years, with fair skin and history of intense sun exposure. The diagnosis is reached through an thorough clinical evalua-tion of the skin lesions, the comorbidities,the risk factors and the biopsy findings. This paper aims to report a case of two patients with aggressive forms of squamous cells carcinoma, a type of non-melanoma skin cancer. They were submitted to a surgical excision in a department of Head and Neck Surgery in Fortaleza, Ceará. The discussion about these reported cases provides insights on the appropriate approaches towards a high risk squamous cell carcinoma of the skin: the ideal surgical technique, indications and contraindica-tions of adjuvant therapies.