This article refers to the case of a 57-year-old female patient admitted in our clinic for a recurrent giant sacrococcygeal and gluteal squamous cell carcinoma. In the past, excisional biopsy was performed in another clinic of plastic surgery, followed by tumor excision,chemotherapy and radiotherapy for 6 months. After one year, the patient addresses our clinic for giant tumor recurrence in the sacrococcian region and bilateral buttocks. The MRI examination carried out highlights a tumor formation that invades both gluteal regions up to the level of the piriformis muscle and the sacrum. No metastases are evident in the pelvis, abdomen and chest. The oncological evaluation recommends surgical treatment to remove the tumor followed by local radiotherapy according to the protocol.The surgical treatment consisted of wide excision of the tumor formation and local reconstruction with two musculocutaneous rotation flaps of the gluteus maximus muscle.