Squamous cell carcinoma in situ (SCCis), also known as Bowen's disease, is a common superficial malignancy of the skin. Treatment of SCCis is important to prevent invasion into the dermis as well as metastases. Treatment of SCCis may be challenging based on the location of the tumor, advanced age, immunosuppression, medical comorbidities, or desire for noninvasive treatment. SCCis on the lower leg can be particularly challenging to treat due to poor wound healing in the setting of suboptimal circulation. This report reviews the evidence for various treatment options of SCCis, including their advantages, disadvantages, and efficacy, with an emphasis on treatment of SCCis of the lower extremity. Treatment options discussed in this contribution include wide local excision, Mohs micrographic surgery, cryotherapy, curettage, imiqimod, 5-fluorouracil, 5-fluorouracil and calcipotriol, ingenol mebutate, tazarotene, photodynamic therapy, acitretin, laser therapy, and radiotherapy.