Microcystic adnexal carcinoma (MAC) is a rare adnexal tumour which has only recently been recognized as a separate clinicopathological entity. It typically affects the face of the middle-aged and often requires extensive surgical excision, due to its locally invasive nature. Its clinical significance is that, despite being locally invasive, MAC is typified by a lack of metastatic spread. We present a case and review of the literature.