Basal cell carcinoma (BCC) is the most common cancer worldwide. Early identification can be made clinically, aided by dermoscopy, in addition to newer imaging technologies such as reflectance confocal microscopy. BCC most commonly demonstrates an indolent course responsive to local destruction or surgical removal. Mohs micrographic surgery is the most effective treatment, especially for high-risk tumors. Low-risk tumors may be amendable to nonsurgical treatment including topical and destructive therapies. Radiation therapy can be used in patients not amendable to surgery. Advanced and metastatic BCC can be treated with Hedgehog pathway inhibitors and other systemic agents with varying responses.