Introduction: Squamous cell carcinoma (SCC) is one of the most common types of skin cancer in Caucasians, but the role played by ionizing radiation (IR) exposure in its etiology is unclear. Case Presentation: This study presents a patient with SCC, actinic keratoses, and radiation dermatitis of the feet with a distant history of IR exposure from a shoe-fitting fluoroscope. It is likely the fluoroscope’s IR contributed to the etiology of these manifestations. Conclusions: Patients with a history of repeated IR exposure, particularly from older, unregulated sources such as a shoe-fitting fluoroscope, should be monitored with a high index of suspicion for skin cancer and other related problems.