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¹Doctor Ram Manohar Lohia Institute of Medical Sciences, Department of Neurosurgery, Lucknow, India DOI : 10.5137/1019-5149.JTN.19895-17.1 Cranioplasty is a commonly performed procedure following decompressive craniectomy. The patients are usually young earning persons and increasing cost of treatment is difficult to bear especially in low and middle income countries. A variety of options are available for cranioplasty ranging from autologus bone graft to xenograft and synthetic materials. Presently the autologous cryopreserved or subcutaneously preserved bone graft is considered as the preferred choice, but it has the drawbacks of bone resorption and infection. Custom made titanium implants and polyetheretherketone implants, which are manufactured using 3D printing technologies, are also being used. However, their use is limited because of high cost and lack of availability of these technologies in the developing world, which have the maximum number of such cases. The authors present an easy and low cost technique for making a customised cranioplasty implant by polymethylmethacrylate using the craniotomy bone flap of the patient as a template. Keywords : Cranioplasty, Decompressive craniectomy, Polymethylmethacrylate