Patients with craniofacial microsomia comprise a diverse clinical cohort that requires individualized attention and surgical consideration that benefits from multidisciplinary team management to optimize functionality and esthetics. Specific concerns regarding airway, vision, feeding, growth, hearing, speech, development, and quality of life may require intervention. The full reconstructive ladder may be utilized in the care of these patients. Ultimately, tailoring surgery to optimize final facial symmetry while minimizing the burden of surgical interventions serves these patients well.