Carcinosarcoma is a biphasic tumor composed of intimately admixed malignant epithelial and mesenchymal components. Primary cutaneous cases are extremely rare; there are with only 18 cases documented in English literature to date. We present a case of a 55-year-old woman with a primary carcinosarcoma of the scalp. Histologically, the lesion consisted of an undifferentiated spindle cell sarcomatous component admixed with a resembling malignant tumor with eccrine differentiation. Immunohistochemistry showed the epithelial component to express cytokeratin and EMA and lack of vimentin expression. In the sarcomatous component, the staining pattern demonstrated the reverse. The patient received adjuvant radiotherapy; but one month later a recurring nodule developed at this site, and two months later, metastasis to the neck lymph node developed. There is no evidence of recurrence or metastasis after 25 months of follow-up.