The neurosurgical literature lacks large series highlighting calvarial tumors. Lesions of the calvarium may originate from the bony structures or may be secondary to invasion of scalp-based lesions or brain-based lesions into the skull vault. The clinical and radiological features are often nonspecific. However, recognition of benign and malignant imaging features is important for the radiological diagnosis, management, and also monitoring and follow-up. The management of patients with calvarial lesions should be interdisciplinary, as with other oncological diseases. The therapeutic strategy is dictated by the risk of progression, aesthetic issue, or compromising of the adjacent structure. The aim of this chapter is to define the outcomes and prognosis factors for scalp and calvarial lesions according to their origin and malignancy.