Introduction: Lateral temporal bone resections (LTBR) are used in the management of locally advanced peri-auricular cutaneous squamous cell carcinomas (cSCCs), but there is still conflicting evidence regarding the staging, surgical and adjuvant treatment decisions. Material and methods: A retrospective analysis was performed on all patients who underwent LTBR for cSCC between January 2015 and December 2019 at a dedicated tertiary oncology referral centre. Results and analysis: Twenty-nine patients were included, with a median age of 77 years. CT, MRI and PET showed good diagnostic accuracy in identifying disease in the parotid gland, external auditory canal, and mastoid bone, but had poor sensitivity in identifying cervical nodal metastasis. Six patients recurred with a median duration of 4.8 months. Tumour differentiation (p=0.0040) and post-operative radiotherapy (p=0.0199) showed significantly better recurrence free survival. Conclusion: LTBR for peri-auricular cSCCs require careful surgical planning using clinicoradiological correlation, particularly in patients with poorly differentiated tumours.