Abstract : Tumours of myoepithelial differentiation have only in the last two decades been recognised to occasionally arise from soft tissue. Malignant mixed myoepithelial tumour of soft tissue is an exceptionally rare diagnosis, with less than 10 reported cases to date. Diagnosis is often challenging due to histological polymorphism, variability of immunophenotype and the absence of a cellular counterpart. A 22-year-old man presented with a seven-month history of an enlarging subcutaneous mass on the occipital scalp, measuring 10x14cm. Following excision under general anaesthetic, histopathological and immunohistochemical analysis demonstrated features most in keeping with a malignant mixed tumour of soft tissue. A further 2cm wide local excision was performed, followed by post-operative radiotherapy; to date there has been no recurrence. Soft tissue myoepithelial tumours can be up to 20cm in size, with larger size often associated with malignancy. The size of the tumour in this case enabled primary closure for both excision and wide local excision.