Elliptical excision is a standard form of treatment for cutaneous neoplasms, but routine pathologic sectioning results in incomplete histologic control of surgical margins. The objective was to describe a technique of complete histologic margin control for tumors removed by excision as an ellipse. A retrospective study of 100 consecutive nonmelanoma skin cancers of the head and neck removed using elliptical excisions with complete histologic margin control was performed. The technique is described and depicted in detail. Seventy-one tumors were removed in one excision, and 29 required additional excisions for complete histologic tumor clearance. Linear repairs were used for 93 tumors. Elliptical excision, combined with our technique of complete histologic margin control, provides a simple, efficient, and effective method for surgical removal and repair of nonmelanoma skin cancers and provides an alternative variation of performing Mohs micrographic surgery for selected tumors.