During the last 20 years, an increasing incidence of basal cell carcinoma (BCC) has been demonstrated by several studies. A ten-year retrospective analysis on 7,266 cases of primary BCC of the Department of Dermatology and Plastic Surgery of the University of Rome La Sapienza and the Department of Dermatology of the University of Naples "Federico If' is reported. Among a population aged over 35 years, BCC cases increased from 618 in 1994 up to 749 cases in 2003, while among the younger population (<35 years), BCC cases increased from 30 in 1994 to 47 cases in 2003. Anatomic site distribution of BCC among people aged <35 years was: head and neck=51.54%, trunk=41.40%, limbs=5.91%, others= 1.12%. On histological examination aggressive-growth BBC was recorded in 48 out of 355 cases (13.52%) among people aged <35 years and in 841 out of 6,755 cases (12.45%) among patients >35 years. In conclusion, an increasing incidence of basal cell carcinoma among young people over the past 20 years was reported. No significant difference in tumour aggressiveness between the young and the elderly patients was observed.