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Cranioplasty is the surgical repair of a defect or deformity of the skull. Historically, many techniques have been developed and tried, with variable success. More recently there has been a move towards the use of computer-generated custom prostheses, fabricated from either titanium or polymers. Nevertheless, there is still a role for autogenous materials. Cranioplasty is not a risk-free procedure, and therefore case selection, planning and surgical technique must be carried out to the highest degree of precision. Some of the more important factors and choice of materials are discussed in this chapter.