Trepanation is considered one of the oldest surgical procedures in the world, of which the earliest evidence goes back to the Mesolithic. Over 130 cases of trepanated crania have been documented in the recent prehistory of the Iberian Peninsula, one of the areas with the highest number of cases. This paper analyses and discusses a new case from northern Spain. The cranium was found in the site of La Saga, Cáseda, Navarre, a small tomb where nine individuals were simultaneously placed at the end of the Bronze Age. It belongs to an adult female and displays a pentagonal hole in the central area of the cranial vault over the sagittal suture. The pentagonal shape of the injury, its regular outline, and the presence of 10 fusiform and two rounded grooves suggest that the bone was intentionally removed by means of cutting and leverage, a technique documented in another example from the Iberian Peninsula. Neither cranial lesions nor pathological evidence have been identified to justify the surgical procedure. Furthermore, the case is exceptional due to the presence of superficial and parallel cut marks in longitudinal and transversal directions across the parietal and temporal bones, unequivocally associated with scalping practice, and which would be performed prior to the trepanation in order to facilitate it. The absence of any kind of healing or bone regeneration points towards the death of the individual during the procedure. Together with the presence of marks of violence and manipulation of the skeletal remains of some individuals buried in the same grave, this leads us to propose that the trepanation was possibly performed to heal a previous trauma resulting from a violent conflict that caused the death of this and eight other individuals from the community.