Squamous cell carcinoma (SCC) arising in a burn scar, known as a Marjolin ulcer, is a rare aggressive skin cancer. We describe a case of a 63-year-old patient with squamous cell carcinoma arising from a 24-year-old thermal burn scar on the dorsal aspect of the left metacarpus. The lesion exhibited gradual ulceration. Local treatment was ineffective. Following histopathological verification and additional diagnostic workup, surgical intervention was undertaken. This consisted of complete resection of the lesion, with simultaneous coverage of the defect using an autologous intermediate-thickness skin graft harvested from the patient’s thigh. The described case emphasises the importance of early diagnosis, regular follow-up of burn scars, and prompt intervention, all of which contribute to improving patient prognosis.