Craniosynostosis presents challenges in pediatric anesthesia, particularly during cranial vault reconstruction. Case Presentation: We report a 1-year-old female with craniosynostosis scheduled for orbitofrontal advancement. Anesthesia induction included ketamine, midazolam, and propofol, with atracurium for muscle relaxation. A hybrid intubation technique using C-MAC and fiberoptic bronchoscope was employed due to anticipated difficult airway. Dexmedetomidine infusion maintained hemodynamic stability. Meticulous intraoperative fluid management and blood loss calculation were performed. Discussion: Thorough airway assessment and multidisciplinary collaboration were crucial. The main takeaway emphasizes tailored approaches to optimize outcomes and minimize complications in pediatric craniosynostosis surgery. Conclusion: Pediatric patients with craniosynostosis undergoing cranial vault reconstruction require individualized anesthesia management. A comprehensive approach guided by multidisciplinary collaboration is essential for successful outcomes.