By virtue of its tissue sparing properties and assessment of 100% of the margin of excised specimens, MMS is regarded as the gold-standard surgical treatment of high-risk non-melanoma skin cancers of the head and neck. From its original inception in the 1940s, modern day MMS has evolved to become a fresh tissue surgical technique, using frozen section margin control performed under local anaesthesia in an out-patient or day-case setting. In the UK, the increasing burden of skin cancer has resulted in a greater demand for MMS with over 32 units across the country providing the technique. This article is protected by copyright. All rights reserved.