Malignant nodular hidradenoma (MNH) is rare, highly malignant, primary skin tumor which may have both apocrine and eccrine variants. MNH has peak incidence in the sixth decade of life; with an equal male/female distribution. Scalp is a known but it is unusual site of occurrence. Wide local excision is the treatment of choice with clearances of 2 cm recommended. Selective lymph node dissection is often used. The value of adjuvant radiotherapy has not been confirmed. As early recurrence is common despite the wide excision close follow-up is mandatory.