A 59-year-old female patient presented with one year history of an enlarging left cheek mass. The mass was measured about 6 cm by 4 cm in diameter and the lesion accompanied skin color change to red and vascularization. Contrast enhanced neck magnetic resonance imaging (MRI) showed malignant tumor with suspicious involvement of the skin, but no infiltration of bone. A punch biopsy confirmed the diagnosis of basal cell carcinoma (BCC), and total whole body FDG positron-emission tomography (PET) imaging showed no suspicious metastatic hypermetabolic lesions. She referred to department of plastic surgery and was treated with wide surgical excision. BCC is the most common non-melanoma skin cancer, and its incidence is increasing worldwide. BCC generally grows slowly and has favorable prognosis. Giant BCC is a rare type of BCC, with less than 1%, which is defined as a tumor with larger than 5 cm in diameter. Contrary to natural course of general BCC, giant BCC is known to behave aggressive, which can invade and destroy the surrounding structure such as muscle and bone. However, treatment of giant BCC has not yet been established because of rarity of this tumor. Multidisciplinary approach is needed for treatment of giant BCC. We herein report the interesting case of giant BCC of the cheek.