Basal cell carcinomas (BCCs) are slow-growing keratinocyte tumours. There are few reports in the literature reporting the natural history of untreated BCCs. We evaluated the natural progression of BCCs and patient outcomes while awaiting surgical intervention. Only patients with histologically proven BCCs were included in our analysis. Retrospective data analysis was performed for a sample of 55 patients (in total, 70 lesions). There was a significant correlation between the average growth of BCCs and the time waiting for a procedure, with 20% of patients requiring a more complex procedure than originally planned at the time of booking. The top three most frequently reported symptoms were itching (39.4%), crusting (36.4%) and bleeding (30.3%). We report a positive relationship between BCC growth and the length of time from initial presentation to surgical treatment. Patients with long waits often exhibited more symptoms and required more complex surgical procedures than originally planned, especially for BCCs in the head and neck.