The goal of this retrospective study was to identify factors that predict the recurrence of basal cell carcinoma of the head and neck. We reviewed the medical records of 165 patients who had undergone a wide surgical excision (negative margins) of one or more basal cell carcinomas of the head and neck. Univariate analysis revealed that recurrence was significantly influenced by the patient's gender (p < 0.01), the presence of preoperative risk factors (p < 0.05), the presence of multiple lesions (p < 0.01), and their histopathologic subtype (p < 0.05). Multivariate analysis revealed that the best predictors of recurrence were the presence of preoperative risk factors and the presence of multiple lesions (p < 0.01); the lesion's histologic subtype approached but did not reach statistical significance in predicting recurrence (p = 0.06).