Craniofacial anomalies contribute to one third of all congenital deformities, and are often observed with syndromic genetic conditions such as Crouzon or Treacher-Collins syndrome. Reconstructive plastic surgeons are a crucial member of the care team for these patients, and many specialize in the repair of craniofacial anomalies. Chapter four will focus on the etiology, surgical reconstruction, and perioperative care for the more common congenital facial defects, including cleft lip and/or palate and craniosynostosis. Technological advancements in the field of reconstructive surgery have led to the development of image-guided surgery and individualized cutting templates (osteotomy) among others, and the role of these advancements will be discussed in each section when applicable.