| Summary: | Introduction: Basal cell carcinoma (BCC) of the skin is common. The genitalia is rarely affected as it is naturally protected from ultraviolet light (UV) exposure. Predisposing factors and clinical features of BCC affecting the genitalia still require further description. Observation: We present an elderly man with a scrotal lesion of 31 years duration which was confirmed to be BCC of the nodular and cystic type by histopathological examination. He did not have any known risk factors for genital BCC. There was no local invasion or distant metastases despite the tumour’s large size and prolonged duration. Wide local excision was performed. There was no evidence of recurrence at 6 months. Conclusion: BCC should be considered in the elderly with chronic skin lesions at the genitalia. Multiple factors contribute to delayed presentation. Keywords: Basal cell carcinoma, Scrotum, Genital region, Skin cancer
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