Over the past 15 years, conceptual and technical advances have occurred in the management of the infant with Apert syndrome. There is greater understanding and hence documentation of the neurologic and developmental associations of Apert syndrome. The technical progress is measured in the maturation of former ad hoc, if not random, operative craniectomies, to current deliberate planned strategies with regard to management of hydrocephalus, synostosis, orbital expansion, and forehead advancement. The future will likely bring the prenatal diagnosis of Apert syndrome into even greater focus. That notwithstanding, management techniques are likely to change little in the next decade.