Purpose: Basal cell and cutaneous squamous cell carcinoma are the most common malignancies worldwide – together they represent a major source of presentations to tertiary plastic and reconstructive surgery units in Australia. While simple lesions on the trunk and limbs are often excised in primary care, many lesions arise on the head and neck which are inherently high-risk from an oncological perspective and can pose a reconstructive challenge, often involving complex 3D structures and requiring complex techniques to reconstruct the remaining defect. Method: A 5-year retrospective study was undertaken at the Department of Plastic and Reconstructive Surgery at the Royal Hobart Hospital, Australia. Data were collected on all non-melanoma skin cancers excised during the study period including operative and histopathology reports. This study was approved by the Human Research Ethics Committee of Tasmania (H0018554). Results: 1856 lesions were excised during the study period, 1261 BCC and 595 cSCC. 78% of lesions occurred on the head and neck. The most frequently involved anatomical sites were the face (29%), nose (19%) and ear (11%). Lesions excised from the head and neck were significantly more like to be excised with either close or positive margins (OR = 3.6, p < 0.0001, 95% CI = 2.1-6.3) than those in other anatomical sites. Conclusion: The majority of lesions were high-risk, located on the head and neck, with relatively few lesions located on the trunk or limbs.