Twenty-two major skull reconstructions were done using autogenous rib or iliac bone. When bone from the rib was used, it was split and wired in place over a bony lip formed at the edge of the defect. Iliac crest was fitted as a keystone in an arch and fastened with wire. Functional results were perfect in all but two cases, and aesthetic results excellent in all but two. In each case, the unsatisfactory results were directly due to inattention to operative detail. There were no losses of grafts, and no significant infections. Autogenous bone to reconstruct the calvarium gives excellent aesthetic and functional results when the technique described is followed.