The scalp covers the skull and is composed of five layers of skin, subcutaneous tissue, cap aponeurosis, subaponeurosis loose tissue, and periosteum. There are two layers of the temporal fascia and temporalis muscle deep in the subaponeurotic loose tissue. Based on the classification of the primary part of the disease, scalp malignant tumors can be divided into primary malignant tumors of the scalp and metastatic scalp cancer. When they are classified according to histological origin, primary malignant tumors of the scalp include squamous cell carcinoma, basal cell carcinoma, dermatofibrosarcoma protuberans, malignant melanoma, pilomatrix carcinoma, sebaceous gland carcinoma, fibrosarcoma, and angiosarcoma. In addition, scar cancer caused by the malignant transformation of scalp scar tissue is also a common malignant tumor originating in the scalp. Metastatic scalp malignancies originate from other sites and are histologically consistent with the primary lesion. Generally, the treatment of malignant scalp tumors includes photoelectric therapy, surgery, radiotherapy, chemotherapy, targeted therapy, immunotherapy, and other methods, among which surgical resection is the most common treatment method. This chapter will introduce common primary and secondary malignant tumors of the scalp, as well as common surgical treatments.