Objective: To determine the recurrence rate of basal cell carcinoma (BCC) after surgical excision., Design: Retrospective., Method: The records of all 139 patients treated for BCC at the Department of Plastic Surgery and Hand Surgery, Leeuwarden Medical Centre, Leeuwarden, the Netherlands, in 1992 were reviewed. This was done by examining case histories and additional information was obtained from dermatologists, general practitioners, patients and the Dutch National Automated Pathological-Anatomical Archive. One hundred and twenty-six BCCs were investigated in 108 patients: 51 men and 57 women, with a mean age of 66 years (range: 24-92). Of these BCCs, 114 had not been previously treated and 12 were a relapse. Freeze section analysis was carried out during the excision if a sprouting or deep growth was suspected and if a tight excision or reconstruction with transposed or rotated piece was desired., Results: The mean follow-up was 59 months (range: 5-86). Sixty-one BCCs on which frozen section analysis was performed were excised completely. In 65 BCCs which were excised without frozen section analysis, a second operation was necessary on 11 occasions to obtain histologically free margins. In both groups a tumour recurred on one occasion (2/126; 1.6%)., Conclusion: Surgical treatment of BCC aimed at free histological margins, results in a recurrence rate of 1.6%.