This case reportconcernsa 78years old woman with a lesion of the lower lip who is referred by a dermatologistfor surgical treatment to the University Hospital “St. George” in Plovdiv, Bulgaria. An excisional biopsy was done and sent for examination. Тhe result showed low-grade Squamous cell carcinoma of the lower lip. A CT scan of the head and neck was performed, which showed no metastases in the regional lymphatic basin. A specialist radiologist was consulted in advance. Although the cancer is poorly differentiated we decided not to use preoperative radiotherapy due to the small size of the lesion and the lack of metastases in the regional lymph nodes. Under general anaesthesia, a surgery was performed to completely remove the carcinoma and subsequent plastic surgery according to Abbe-Estlander flap, using some modification by moving an artery, a vein together with the used flap from the upper lip. Introduction: One of the most frequent malignant lesion of the oral cavity is the lip cancer. Squamous cell carcinoma is assumed to be one of the most well-known diseases of oral cancer. One of the risk factors for development of lip cancer is the sun exposure. Squamous cell carcinoma must be diagnosed with histological findings. Purpose: Presenting a case of a 78years old patient with a lesion of the lower lip undergoing operative treatment to remove alow-grade squamous cell carcinoma of the lower lip. Material and Methods: The examination reveals a lesion of the lower lip. One of the main diagnostic methods in this case is the biopsy. The excisional biopsy showed low-grade squamous cell carcinoma of the lower lip. Treatment for lip cancer is primarily surgical and dependson the extent of the lesion as well as its location. The main goals of the surgeonsare extirpation of all tissue involved with cancer including the primary lesion, functional reconstruction of the lip and facial cosmesis and return to daily activities. In this case we used a modified Abbe-Estlander flap to achieve all our goals. Results: The patient has satisfactory results in terms of aesthetic and functional outcome. Conclusion: The aim of the current work is to report a case of surgical therapy of the lower lip using a modified Abbe-Estlander flap. This method is safe and provides functionally and aesthetically pleasing result and affords versatility in flap design.