CutaneousCutaneoussquamous cell carcinoma (SCCSquamous cell carcinoma (SCC)) is the second most common cutaneousCutaneous malignancy in the United States (USA), and among Caucasians, the second most common cancer overall. Although the majority of cases are cured by surgery or other treatmentsTreatment, deaths from SCCSquamous cell carcinoma (SCC) are estimated to equal those from melanomaMelanoma. Precise estimates of disease-related outcomes for SCCSquamous cell carcinoma (SCC) have been challenging since they are excluded from most national cancer registries, including those in the USA. Identification of patients at risk for poor outcomes, including metastasis and death from disease, as well as clarity regarding appropriate management of high-risk and advanced tumors is essential for optimizing management but has been challenging due to a lack of consistent guidelines. This chapter discusses the current state of knowledge regarding the pathophysiology leading to cutaneousCutaneousSCCSquamous cell carcinoma (SCC), risk factors for its development, and the clinical spectrum of squamous dysplasia with particular attention given to high-risk and invasive disease. It provides an in-depth discussion of the available data regarding surgical and medical management of cutaneousCutaneousSCCSquamous cell carcinoma (SCC), particularly of high-risk and metastatic tumors.