Craniofacial osseointegration has been hailed as the most significant advance in maxillofacial prosthetic restoration over 25 years. It provides a particularly unfortunate group of patients, who previously may have had few treatment options, with new reconstructive opportunities. This paper outlines the surgical and prosthetic techniques of craniofacial osseointegration. Treatment outcomes in terms of individual implant success rates are described and the role of hyperbaric oxygen is considered. The need for future avenues of development are also discussed. Craniofacial implants have become an integral part of the treatment options available for head and neck reconstruction. It is important that this care is provided within a multidisciplinary clinical-research environment.