Reconstruction of the facial skeleton and cranial vault has always posed difficult problems. To obtain a good result, various autologous, homologous, and heterologous grafts and biomaterials can be used. In this work, the authors present their experience in the use of methyl methacrylate (MMA) presenting a simple technique for application of the material that reduces the risk of complications. The authors also performed a review of the international bibliography relative to the use of MMA as an autologous bone substitute, analyzing the risks, complications, and results obtained.Between October 2003 and September 2007, the authors used MMA in procedures of cranial reshaping on 9 patients who underwent surgery to repair the damage caused by cranial-facial traumas and malformations.The technique of layered application of MMA made it possible to obtain excellent aesthetic and functional results in 8 patients, whereas in 1 case, the material had to be removed when the patient developed complications due to infection.Methyl methacrylate still remains the material of choice for cranioplasty on adult patients. The application of the material and sequenced layers makes it possible to reduce perioperative complications to the utmost, providing an excellent aesthetic and functional result.