Virtual surgical planning (VSP) stands as a novel advancement in craniofacial surgery. Since its inception, VSP has had the ability to improve accuracy and consistency in craniofacial surgery. The current case report describes the use of VSP in the context of a pediatric growing skull fracture and large calvarial defect requiring autologous reconstruction. Emphasis is placed on patient-specific osteotomy design and cutting guide design to decrease risk and optimize surgical outcomes. This case report illustrates a unique application of VSP in craniofacial surgery.