Surgical treatment of giant congenital melanocytic nevus faces many difficulties due to the large diameter of the lesion and the need for early treatment especially in young children. The study was conducted to evaluate the results of tissue defect coveragefollowing tissue defects to remove it because of the proposed selection method, suitable shaping techniques. From 2006 to 2010, the authors have operated 44 processes on 20 patients. Among them: 16 serial excision times, 16 skin grafts times, 6 tissue expansion times and 6 times using other techniques. The results showed that almost surgical, with serial excision: good 100 percent, with skin grafts: a good 81 percent, fairly 19 percent, with tissue expansion: 83 percent good, 17 percent fairly. Inconclussion: surgical treatment of giant congenital melanocytic nevus can be performed in many different techniques but mainly by serial excision, skin grafts and tissue expansion.