Introduction: Non-melanoma skin cancers (NMSC) represent a significant global public health burden, particularly in highincome countries. The increasing incidence of head and neck NMSC contributes to rising morbidity and necessitates multi-disciplinary management. Objectives: This study aims to evaluate the incidence, demographic distribution, histological subtypes, and seasonal variation of NMSC over a five-year period at a tertiary center in Romania. Materials and Methods: A retrospective observational study was conducted from January 2020 to December 2024, including 180 patients diagnosed and treated for malignant skin lesions. Data were extracted from clinical and histopathological records. Chi-square tests assessed seasonal distribution, and Mann-Whitney U tests compared lesion depth and surface area between demographic groups. Results: A total of 388 malignant lesions were recorded. Basal cell carcinoma (BCC) was the most common subtype (n = 168), followed by squamous cell carcinoma (SCC) (n = 25). Most patients resided in urban areas, particularly Bucharest. Males presented with significantly deeper lesions (mean: 1.5 mm) compared to females (mean: 1.25 mm; p = 0.009). Seasonal analysis revealed a significant variation in incidence, with the lowest number of cases in spring (χ² = 10.31, p = 0.016). Conclusion: The incidence of malignant skin lesions increased from 2020 to 2023, followed by a decline in 2024. Seasonal and sex-related differences were observed, with the face being the most frequent site of involvement. While the sex distribution was relatively balanced, males exhibited significantly greater lesion depths compared to females.
