The Objective of this study is to show the versatility of polymethylmethacrylate (PMMA) in secondary correction of craniofacial defects. The goal of secondary correction is permanent cerebral protection in an esthetically acceptable fashion. Reconstruction of cranial defects can be performed with several different materials and methods. Alloplastic materials, such as poly eth-methacrylate, is an alternative frequently used at our institution. We have shown cased case reports of 4 patients who has underwent secondary correction using polymethylmethacrylate. We have show cased case reports of who have underwent the use of intraoperative fabricated PMMA and prefabricated PMMA. Three patients underwent intraoperative fabricated PMMA correction while one had prefabricated PMMA. The esthetic results and post-surgical outcome were excellent. All though recent advances in CAD/CAM assisted implants have come, PMMA has proved to be cost-effective and highly versatile when it comes to surgical correction of craniofacial skeleton.