Reconstruction of large calvarial bone defects is considered as a one of the most difficult challenges in reconstructive surgery. Such reconstruction is usually performed for cosmetic reasons. However, in some cases. It is considered as a necessary for protection of the underlying brain tissue from a potential trauma. Autogenous bone grafting remains the most effective reconstructive material. However, several limitations are present with this technique, such as possibility of donor site morbidity as well as bone graft resorption. Alloplastic implants may appear to be an acceptable alternative for autogenous bone grafting. Use of acrylic bone cement (one of alloplastic implants) can be considered as a successful reconstructive material for reconstruction of large cranial bone defect without major complication. Less than ten minutes was needed for mixing and setting the bone cement which saves the operation time. Copious coolant is essential during setting time of bone cement to prevent any damage to the underlying brain tissues.

Conflict of interest: None declared.