Extraskeletal osteosarcoma (ESOS) is a rare, soft-tissue sarcoma comprising approximately 2% to 4% of all osteosarcomas.1 ESOS is defined as a malignant mesenchymal neoplasm composed of cells that produce osteoid, bone, and/or chondroid material, with no attachment to the underlying bone or periosteum.2 The skin may be involved in the setting of widespread metastatic dissemination from a skeletal or extraskeletal osteosarcoma, or as a primary cutaneous osteosarcoma. Herein, we present a case of a primary cutaneous osteosarcoma of the head and neck.