Twelve cases of epidermoid carcinoma of the nasal vestibule with a median follow-up of three years were reviewed to evaluate effectiveness of current treatment modalities. Patients were initially treated by surgery, irradiation, or a combination of both therapies. The authors conclude 1. epidermoid carcinoma of the nasal vestibule is an aggressive disease; 2. once metastases have occurred, they are poorly controlled by surgery and/or irradiation; and 3. initial therapy should be directed to both control of the primary and prevention of distant metastases.