OBJECTIVE: Accounts of bony human horns originating from the cranium are found peppered throughout the early medical literature. This study reviews the extant literature regarding these entities to elucidate their authenticity. METHODS: We reviewed both historical and current literature as well as osteological material from our anatomy laboratories for accounts or observations of bony outgrowths of the calvaria in humans. RESULTS: Human horns seem to be mentioned more frequently in the historical literature and are documented primarily with drawings. Moreover, from early accounts, it is often difficult to distinguish true large bony outgrowths from scalp excrescences. Only two cadaveric specimens from our laboratory were noted to have small anomalous bony protuberances, one on the occiput and one on the frontal bone. CONCLUSION: With the lack of either photographic or extreme dry specimen evidence of such human horns, we would propose that benign calvarial tumors, such as osteomas, may have initiated speculation that such entities, i.e., horns, exist in humans but that scalp lesions, exaggeration, legend, and religious beliefs have historically propagated these entities to a mythical status. In addition, early surgical intervention and changes in nomenclature may have also decreased the frequency of such sightings. Finally, many early descriptions have not been repeated in recent history, even in third-world countries lacking advanced medical care.