OBJECTIVE To establish the anatomical site distribution of cutaneous squamous cell carcinoma (SCC) in organ transplant recipients (OTRs) with regard to age and sex. METHODS Retrospective population-based cohort study of OTRs. METHODS Patients who underwent organ transplantation in Sweden from January 1, 1970, to December 31, 1997, registered in the Swedish In-patient Registry and national Swedish Cancer Registry. METHODS From the cohort of 5931 OTRs, we could include 179 patients with 475 cutaneous SCCs. Information on the sites was received from the cancer registry and from the histopathological reports. RESULTS The site of each SCC was registered in a computer program displaying the results on a 3-dimensional human figure. The head and neck were the predominant sites in male patients, and the trunk was the predominant site in female patients. The most common site in younger patients (born in 1940 or after) was the chest; and in older patients, the face. The ear was a common site in male patients, but, in contrast, no tumors were located there in female patients. Overall, the OTRs were younger compared with the overall Swedish population with cutaneous SCC. CONCLUSIONS There are differences in the anatomical site distribution of cutaneous SCCs in OTRs with regard to sex and age, and with regard to the general distribution in Swedish patients. The level of sun exposure is considered the most important factor in explaining those differences, and highlights the importance of sun avoidance in this group of patients.