Aims: To determine the incidence of level 1A nodal metastasis in patients undergoing surgery for metastatic cutaneous squamous cell carcinoma (cSCC) of the parotid gland, and to evaluate the oncologic safety of using the submental island flap for reconstruction. Methodology: A retrospective cohort study of 120 patients aged 18 years old and above who underwent parotidectomy for metastatic cSCC between February 2000 and February 2025. Patient subgroups were stratified into five groups based on 1A status, 1B involvement, and the presence or absence of 1A recurrence at five-year follow-up in those without level 1 dissection. Demographic, histopathological and surgical data were analysed to identify predictors of 1A involvement. Results: Level 1A involvement was identified in 4.2% of patients with metastatic cSCC of parotid gland, all of whom underwent therapeutic neck dissection. Among these patients, 80% demonstrated multilevel nodal involvement, with a median of 5 levels affected and a median nodal burden of 14 positive nodes. Notably, patients with no initial level 1 dissection did not develop isolated 1A recurrence within 5-year follow-up, irrespective of adjuvant radiotherapy status. In cases of elective neck dissection, rate of occult nodal involvement was 9.09%. Conclusion: Level 1A nodal involvement in metastatic parotid cSCC is uncommon and occurs predominantly in patients with extensive, clinically evident nodal disease. Routine level 1A dissection may not be necessary in clinically node-negative necks and support the oncologic safety of submental island flap reconstruction in appropriately selected patients.