The neurosurgical treatment of acromegaly is well established, but little has been written about correction of the facial deformities of this disease. Although hypertrophy of the skin and subcutaneous tissues may decrease after successful treatment of the pituitary tumor, there is no reversal of the bony changes. An acromegalic patient is presented whose facial deformities were repaired in stages by mandibular osteotomy and soft tissue excision. The history and pathology of acromegaly are reviewed.