Basal cell carcinoma (BCC) is a malignant tumor that may arise in skin damaged by sunlight and ionizing radiation in burn or vaccination scars. Clinical variants of BCC include nodular, morphea type, superficial and polypoid. Tattoo reactions are histologically diverse and can be classified in three main classes: 1) Allergic, granulomatous, and Lichenoid reactions; 2) Inoculation and infectious lesions; 3) Coincidental lesions. The patient reported here was a 72 year old woman with an erythematous fungiform lesion on her upper lip just on the tattooing line for 2 years, confirmed to be BCC on routine histopathology exam. Tattooing might be responsible for the development and unusual presentation of BCC in this case.