Mohs micrographic surgery is a versatile technique for the treatment of nonmelanoma skin cancers, especially recurrent, invasive, or infiltrating basal cell carcinomas. It provides unsurpassed cure rates by using 100% surgical margin control, and it achieves maximal preservation of normal tissue. At the conclusion of tumor extirpation, the defect is ready for immediate reconstruction. With better understanding of the Mohs micrographic surgery technique, it can be more effectively used as part of a coordinated multidisciplinary approach to the treatment of patients with difficult cutaneous and paracutaneous neoplasms.