Cutaneous angiosarcoma (AS) of the face and scalp of the elderly is a rare malignant tumour with a very poor prognosis. The variable presentation and the benign appearance of the cutaneous AS may often delay the correct diagnosis. Because it is extremely aggressive, only early detection and treatment can modify the prognosis. We describe a case of an old man who was diagnosed of AS of the face and scalp 1 month after developing the cutaneous lesion. After treatment with placitaxel, the lesion completely diminished. Unfortunately, he developed pulmonary fibrosis and died 6 months after diagnosis. Predisposing factors of this entity are also discussed.