Background: Certain facial lesions clinically appear as large pores, and when examined microscopically, they are found to be basal cell carcinomas (BCCs). Objectives: The purposes of this study were to determine the clinical and histologic characteristics of certain large-pore facial lesions, which, on microscopic examination, are found to be BCCs and to identify, if any, a clinical profile of the patients who might be prone to development of such large-pore BCCs. Methods: Microscopic examination of biopsy tissue, obtained from patients who presented clinically with characteristic large-pore lesions of the face during the years 1988 to 2000, was performed. Results: Eleven biopsy specimens from 10 patients who presented with long-standing, gaping pores in the center of the face were shown to be BCCs with features of follicular differentiation and focal keratinization. These patients also had thick, sebaceous skin, and most were users of tobacco. Conclusion: Enlarged pores or pits in the center of the face, present for a long period in patients with thick sebaceous skin, should be examined for evidence of BCC. These large-pore lesions may be BCCs with histologic features of follicular differentiation. (J Am Acad Dermatol 2002;47:727-32.)