Epidermoid cysts are prevalent noncancerous cutaneous lesions known to exhibit unusually extended periods of growth. In this study, we present a remarkable case of an epidermoid cyst located on the scalp, which exhibited a growth period of 76 years, the longest growth time documented in the literature to date. The presence of the mass was noted at birth, and it exhibited gradual growth throughout the years, with a notable acceleration observed during the final 2 years. The patient underwent a surgical excision, and the histopathological analysis was consistent with epidermoid cyst, featuring localized rupture and demonstrating foreign body granulomatous inflammation. This case highlights the ability of epidermoid cysts to manifest as slow-growing entities over an exceptionally prolonged timeframe. Furthermore, instances of rapid growth may be attributed to a combination of mass rupture and inflammatory processes.