Premature craniosynostosis is caused by a premature closure of single or multiple sutures of the cranial vault. It may result not only in aesthetic but also in functional disorders with an occasional ICP increase leading to a dramatic loss of vision. In the 1970s,Paul Tessier published his craniofacial principles for the primary treatment of craniosynostosis. His approach has gained wide acceptance over the previously described craniectomies and bone flaps, especially because of the significant benefits with an acceptably low level of morbidity. The following paper reviews the different kinds of craniosynostoses, their specific clinical manifestations, the necessary diagnostic examinations and the specific surgical procedures and operative results.