In an open-label study we assessed the response rate and posttreatment follow-up of topical imiquimod 5% cream in 5 patients with basal cell carcinoma (BCC) who were not treated with surgical excision after topical immunotherapy. All patients received imiquimod 5% cream 3 times a week for up to 16 weeks, at which time treatment was stopped. Patients were examined at regular intervals for signs of recurrence. All patients experienced resolution of their BCC. In all cases, there was a local inflammatory response during therapy, which resolved after treatment. Recurrences were not observed in any of the 5 patients during the posttreatment observation interval, which ranged from 5 to 13 months. Our experience with imiquimod 5% cream in the treatment of BCC is consistent with clinical efficacy previously reported. With the exception of one severe application site reaction, treatment was well tolerated.