Superficial brachytherapy (BT) is used to treat skin cancers at various locations. In areas of poor vascularization, which are subjected to constant trauma, such as extremities, radiotherapy may cause prolonged healing, poorly treatable chronic ulcerations, and even necrosis, requiring subsequent surgical intervention. In this case study, we report on an elderly patient with basal cell carcinoma located on lower leg that was treated with superficial BT. The cancer was cured, but the patient developed complex and prolonged skin toxicity that eventually resolved after 15 months.