Managing recurrent cutaneous squamous cell carcinoma (cSCC) usually requires a multidisciplinary approach. A 74-year-old male presented a nodular lesion on the posterior skull. The lesion was resected, and the specimen was classified as a cSCC. Posteriorly, the patient presented recurrent disease. He underwent a craniectomy and a skin flap that was taken from the dorsal skin. Due to adverse pathological characteristics, a radiotherapy regimen consisting of 66 Gy in 33 fractions was administered. After radiotherapy, a complete clinical response was documented. These promising novel treatments for recurrent cSCC still need to be explored in prospective clinical trials.