<p>Sebaceous gland carcinoma (SGC) is a rare but highly aggressive adnexal tumor, most frequently arising in the eyelid, while extraocular head-and-neck presentations are uncommon and often misdiagnosed; reported 5-year survival rates range from 50 to 80% in the literature.The potential for regional lymphatic spread, particularly to the intraparotid nodes, has been documented in 10–21% of periocular cases and up to one quarter of extraocular cases, making nodal evaluation a critical component of management. We reviewed patients with histologically proven head and neck SGC treated with curative intent at a tertiary oncology center in Southern India between 2014 and 2022. Eight patients were identified, with a median age of 61 years. The eyelid was the predominant site (<i>n</i>=6), followed by the scalp and preauricular region (<i>n</i>=2). All patients underwent wide local excision with intraoperative frozen section margin assessment. Five patients underwent elective superficial parotidectomy, and metastasis was confirmed in two cases representing 25% of the total cohort and 40% among those who had parotidectomy with one case arising from an eyelid primary and the other from a scalp primary. Adjuvant radiotherapy was delivered to five patients with adverse histopathologic features. After a median follow-up of 24 months, all patients were alive without evidence of recurrence. These findings particularly the observed nodal metastasis underscore the aggressive nature of SGC, the real risk of parotid nodal involvement, and the need for complete surgical excision. Current literature supports considering elective parotidectomy in high-risk, node-negative patients because parotid metastasis is well-documented in case series, though larger studies are still needed to define optimal nodal management.</p>