Malignant peripheral nerve sheath tumours are uncommon aggressive soft tissue sarcomas that originate from peripheral nerves or cells associated with the nerve sheath. Scalp malignant peripheral nerve sheath tumours are extremely rare and the role of multimodality management is unclear. We report a 43-year-old female with scalp swelling and rapid growth. Imaging demonstrated an aggressive lesion with extradural extension. A wide excision with negative margins was achieved and he defect reconstructed by rotational flap. The patient was given adjuvant radiation. A follow-up scan done one year post radiation did not show any recurrence. Malignant peripheral nerve sheath tumours of the scalp are extremely rare and such an extradural extension has not been described earlier.