Basaloid-Squamous Cell Carcinoma (BSCC) is considered a biologically aggressive variation of squamous cell carcinoma (SCC). Wain et al. first reported BSCC as an independent neoplasm in 1986. In the past, it was most likely misinterpreted as atypical SCC. To date approximately one hundred cases have been reported in the literature. The pathognomonic characteristic of BSCC is an intimate association between basaloid and squamous patterns: for this reason a small biopsy specimen may be insufficient for correct diagnosis. In such cases, knowledge of the biological behavior of these tumors (i.e. local aggressiveness and tendency to spread both regionally and at a distance) may prove useful. Prognosis and survival rates are certainly worse than in SCC. Within the upper aero-digestive tract, BSCC is most likely to arise in the supraglottic larynx, the pyriform sinus and the base of the tongue. Treatment should include surgery of the primary tumor and of the neck lymph nodes, followed by radiotherapy. The authors present a new case report indicating the typical feature of this tumor (aggressiveness, synchronous basaloid and squamous histology, supraglottic involvement.