Increasing familiarity with elective reconstructive approaches to craniofacial deformity has led to the application of a similar multispecialty approach to repair of selected cases of massive frontal and upper facial trauma. The fundamental steps in craniofacial reconstruction are outlined. The process of patient selection is emphasized. Illustrative case histories review the management of this type of injury. Contributions from anesthesiology, neurosurgery, ophthalmology, and plastic surgery are required. Specialized facilities for postoperative care are mandatory.