Aim and background: Sarcomatoid squamous cell carcinoma (SSCC) is a rare malignant variant of SCC. Here, we present a rare case of primary cutaneous SSCC of the scalp. Case description: We present a case of a 68-year-old male with a very large pedunculated left scalp mass, first noted several years ago, with rapid expansion of the mass 6 months prior to presentation. The mass was mobile of the cranium and without calvarial involvement. He successfully underwent a wide local excision of the mass with no evidence of recurrence at his 6-month follow-up visit. Conclusion: This case of primary scalp cutaneous SSCC represents a rare head and neck site of involvement. Due to the rarity of primary cutaneous SSCC and very few reports of primary cutaneous SSCC arising in the head and neck, management is guided by case series of SSCC arising in other sites. Surgical resection is the recommended primary modality of treatment, with or without regional lymphadenectomy. Adjuvant radiation therapy may be considered for larger tumors, positive lymph nodes, older age, and high-risk features. Due to the concern for a potentially high rate of recurrence, close follow-up is essential. Clinical significance: Sarcomatoid squamous cell carcinoma is a rare malignant variant of SCC that presents a significant diagnostic challenge, as it shares morphologic and immunohistochemical overlap with other spindle cell tumors. While the majority of SSCC of the head and neck occurs in mucosal sites such as the larynx, the scalp remains an extremely rare presentation, with only a few reported cases in the literature. This review of the literature and case report presents an additional case of primary cutaneous SSCC involving the scalp.