In 2009, the AJCC released the seventh edition staging manual. We aimed to retrospectively apply this updated staging criteria to a cohort of previously treated NMSC treated with radiation therapy (RT) and compare outcomes between the two editions in regard to T classification. Seventy-two lesions were identified. By the sixth edition, there were 38 T2 (52.7 %), 16 T3 (22.2 %), and 18 T4 lesions (25.0 %). We restaged the 72 lesions according to the seventh edition criteria and applied an analysis to determine outcome changes as related to stage. Twenty-nine lesions (40.3 %) had their tumor category restaged. Thirteen (72.2 %) of 18 T4 and all (100 %) T3 lesions were downstaged. Cumulatively, there are now 65 T2 (90.3 %), 2 T3 (2.8 %), and 5 T4 lesions (6.9 %). These restaged lesions showed changes in CR and DFS following RT for T2 (84.2 and 93.1 % to 87.7 and 92.2 %, p < 0.0001), T3 (81.3 and 85.7 % to 0 and 0 %, p < 0.0001), and T4 lesions (66.7 and 72.2 % to 40.0 and 40.0 %, p < 0.0001). The AJCC seventh edition potentially results in a poorer outcome prediction in advanced lesions treated with radiation therapy. The elimination of size and the requirement of specific bone invasion location as a staging criterion have substantially changed the staging pattern and outcome analysis.