Introduction: Therapeutic anticoagulation is essential in patients with prosthetic valves, atrial fibrillation, and history of DVT/PE. The question to stop Warfarin prior to cutaneous surgery is raised frequently in the surgeon's practice. Our objectives were to assess frequency of complications after excisional and simple reconstructive cutaneous surgery in patients who were kept on Warfarin and to analyze the need of withholding medication perioperatively. Methods: A retrospective chart review of patients undergoing cutaneous surgery in a five year period was performed. Out of 512 patients 28 were identified to be on Warfarin, total of 50 procedures were performed including excision followed by primary closure, local rotational flaps or skin grafts while remaining on therapeutic anticoagulation. Results: Charts were reviewed for the presence of ecchymosis, bleeding, hematoma, epidermolysis, skin necrosis, and wound dehiscence. Collected data revealed that complications did not go beyond expected mild bruising and swelling in the early postoperative period. Conclusion: Our study showed that skin resection followed by simple reconstruction was not associated with a statistically significant increase in complication rates when patients remain on Coumadin.