A retrospective analysis of 56 patients who underwent primary external irradiation for squamous cell carcinoma of the nasal vestibule between 1958 and 1983 is presented. The overall 5 year actuarial survival and cause specific survival rates were 64 and 87%, respectively. The 5-year local relapse-free rate after primary irradiation was 80%. Prognostic factors which lowered the local control rate after irradiation included a primary tumor size of 2 cm or more, or involvement of the skin of the ala nasi, columella, lip, cartilage, or bone. Local control was improved in patients who received a tumor dose equivalent to, or greater than, 5500 cGy/25 fractions/5 weeks. Only two patients in whom the primary tumor was controlled developed regional nodal metastases, and elective regional nodal irradiation is not recommended. Four patients (9%) developed significant late morbidity after irradiation. External irradiation is effective treatment for squamous cell carcinoma of the nasal vestibule, and produces high local control and cure rates and good cosmetic results.