The complex three-dimensional (3D) anatomy of the craniomaxillofacial skeleton creates a challenge for surgical reconstruction. Advances in virtual surgical planning (VSP) have enhanced reconstructive outcomes in craniomaxillofacial aesthetic and reconstructive surgery. This technology has been especially useful in spatially complex cases due to the ability to visualize and manipulate 3D configurations of the cranium through virtual surgery, printing of stereolithographic models, fabrication of cutting and positioning guides, creation of prefabricated hardware, and refinements of custom implants. In many cases, VSP results in improved accuracy, efficiency, and reduced operative time compared with traditional techniques. As research and indications expand, VSP will continue to be an integral adjunct to the planning and execution of complex craniomaxillofacial surgeries.