Squamous cell carcinoma (SCC) or keratoacanthoma (KA) development at split thickness skin graft donor sites is a documented but very rare entity. We describe a case in which a patient develops a lesion at his graft site seven weeks postoperatively. Upon pathological review, it was found to be SCC and was excised expediently thereafter. Notably, in reviewing the literature, these lesions tend to develop soon after the trauma of skin graft harvest with over half diagnosed within 3 months and a vast majority within 1 year of the operation. This is in contrast to Marjolin ulcers which take years to develop after the initial burn insult. Given the diversity of autograft indications in the reviewed literature, it seems unlikely that the burns themselves contribute to the development of SCC at the donor site. Our case highlights the need for routine surveillance of graft donor sites postoperatively with an emphasis on catching malignant sequelae.