Cavernous hemangiomas of the scalp associated with vascular tumors of the skull occur rarely in older patients. Giant hemangiomas can cause complications secondary to extensive bleeding. Here we report on a 78-year-old female presenting with a giant ulcerated cavernous hemangioma of the scalp. Before admission to the hospital, she had suffered from severe bleeding of the vascular tumor, with resulting anemia. Because of her cardiovascular disease, the tumor mass, and possible vascular connections to osseous hemangiomas, complete surgical removal of the hemangioma was not indicated. Therefore the superficial ulceration was covered with a split skin transplant. After complete wound healing, no further bleeding occurred.