Metopic synostosis can present with various skull abnormalities for which early surgical treatment can provide significant benefit to the patient. Correction of skull deformities associated with metopic synostosis requires accurate assessment of the full range of craniofacial defects within context of the patient's age. Alteration in the characteristics of cranial bone as the child grows older necessitates modifications in techniques used for bony remodeling. Changes in the rate of brain and cranial vault growth also must be considered for adjustments in fixation methods. Thus, both the patient's age and the severity of aesthetic deformity dictate the surgical techniques used in the correction of metopic synostosis.