A total of 97 cases of metastatic basal cell carcinoma have been reported in the literature, 22 of which were metastatic to bone. To date there has been no survival following bone metastasis. A case report of significant long-term survival—over three times the expected—is presented. The treatment described is perhaps a guideline for management of basal cell carcinoma metastatic to bone, though it is presumed the basic biological nature of the tumor determines length and quality of survival.