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No sponsorships or competing interests have been disclosed for this article. Objective. Evaluate characteristics and risk factors for patients with advanced cutaneous squamous cell carcinoma (cSCC). Study Design. Retrospective case series. Setting. Tertiary care center. Patients and Methods. Chart review of patients with cSCC undergoing a parotidectomy (2003-2012). Results. Of 218 patients identified, 49 % presented with a new primary lesion (n = 107) and 51 % with a recurrence (n = 111). Parotid lymph nodes were positive in 52 % of patients; 81 % had a concurrent neck dissection, and 28 % had cervical lymph node metastases. In 18 % of patients, both parotid and cervical nodes were positive, while 44 % were both parotid and cervical node negative; 33 % had positive parotid and negative cervical nodes