Pigmented Bowen's disease (pBD) or pigmented squamous cell cancer in situ is uncommon, accounting for 1.67%-5.5% of Bowen's disease lesions. It resembles pigmented actinic keratosis, seborrheic keratosis, solar lentigo, atypical nevus, or melanoma, and is ruled out through biopsy. Pigmented Bowen's disease typically presents as an asymptomatic, flat or slightly raised, scaly, and well-delineated plaque that primarily affects individuals in their sixties. Risk factors include human papilloma virus infection, arsenic exposure, sun exposure, ionizing radiation, and trauma.