<p>Recurrent basal cell carcinoma (BCC) presents a significant management challenge. This study aims to investigate the impact of gender, histopathologic subtype, and comorbid conditions on BCCs located in the head and neck region. Furthermore, it seeks to evaluate the influence of sociodemographic characteristics, tumor size and subtypes, and surgical excision margins on recurrence. BCCs histologically confirmed between 2013 and 2023 were evaluated retrospectively. Sociodemographic characteristics of the patients, such as age, gender, and comorbid conditions, were recorded. A total of 925 BCCs from 788 patients were included in the study. Patients ranged in age from 20 to 98 years (mean age: 67.79 ± 13.29), with a female/male ratio of 0.95. Recurrence was observed in 63 tumor lesions. When comparing recurrent and non-recurrent BCCs, tumor thickness, aggressive BCC subtype, presence of perineural invasion, positive surgical margins, reconstruction method following excision (skin graft or local flap), history of organ transplantation, and previous skin cancer were all significantly higher in the recurrent BCCs. The aggressive histopathologic subtype increased the risk of recurrence by 4-fold, perineural invasion by 10.4-fold, and organ transplantation was associated with a 15.6-fold increased frequency of recurrence. In addition, tumor diameter (OR: 1.33 per unit increase) and tumor thickness (OR: 1.166 per unit increase) were identified as independent continuous predictors of recurrence, while the presence of a positive surgical margin increased the recurrence risk by 8.182-fold in the multivariable logistic regression analysis. This study provides valuable insights into the management of recurrent BCCs in the head and neck region.</p>