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Anaesthetic key considerations for cranial vault reconstruction for patients with craniosynostosis include securing the airway, proper positioning, ventilation strategies, maintaining intracranial homeostasis, and careful monitoring of haemodynamics, temperature, and the occurrence of venous air embolism. This case report presents the anaesthetic approach to an infant with isolated non-syndromic sagittal craniosynostosis who successfully underwent cranial vault reconstruction in the sphinx position under general endotracheal anaesthesia maintained with sevoflurane and remifentanil. A thorough understanding of surgical and anaesthetic considerations perioperatively will guide the anaesthesiologist in planning individualised care for a positive patient outcome. Proper discussion with the neurosurgeon and surgical team about perioperative goals for the patient is a vital key to a successful procedure.