Carcinomas arising from chronic pressure ulcers, Marjolin's ulcers, are an uncommon occurrence. They are virulent cancers that require aggressive surgical treatment. We present 3 such cancers including the first report of a squamous cell carcinoma arising in a distal extremity pressure ulcer. Carcinomas arising in chronic pressure ulcers behave more aggressively than other types of Marjolin's ulcers and, therefore, they need to be treated more aggressively. Extensive surgical excisions with wide surgical margins are necessary and elective lymph node dissections should be considered for optimal therapy.