Although basal cell carcinoma (BCC) rarely metastasizes and has a cure rate >95% when diagnosed early in its course, BCC causes significant morbidity and presents an enormous burden to the healthcare system worldwide. Patients who present late in the course of their disease are particularly challenging in that their treatment can be more complicated and less likely to be effective than had they presented earlier. Given the high prevalence of this malignancy and the morbidity associated with a late presentation, healthcare professionals should be familiar with the consequences of neglected BCCs, as well as their management after presentation. Knowledge of patient risk characteristics may allow earlier engagement and diagnosis of patients, before more significant morbidity occurs.