Over a five-year period selected patients with acute facial burns have been treated with early excision and skin grafting. Guidelines on the experience gained are outlined. On admission a tentative diagnosis of the depth of the burn was made and saline dressings were applied. When the patient was considered to be out of immediate danger the wounds were re-examined under anaesthesia following surgical cleaning. Deep dermal and subdermal burns of the face in patients without potentially fatal injuries were tangentially excised (or were subjected to dermabrasion) and covered with skin grafts within the first three days. Deep dermal and subdermal burns combined with potentially fatal injuries were treated conservatively. Early excision and skin grafting performed under optimum conditions give excellent functional and good aesthetic results.