The function of a genioplasty is to produce an aesthetically pleasing chin contour and improve facial proportions. The aim of this study was to review the role of osseous genioplasty in the management of patients with craniofacial deformities. 52 patients (24 males and 28 females) treated at the Australian Craniofacial Unit in Adelaide, Australia over a 25-year period; who required a genioplasty as part of their craniofacial management were reviewed. Patients ranged from 17-44 years (median: 26 years) and the age at which the patients underwent genioplasty was between 9 and 36 years (median: 17 years). Pre and 6 months post op cephalograms were compared, showing a mean chin advancement of 7mm and a mean osseous resorption of 20%. One patient was under-corrected and another had post-operative asymmetry, both requiring repeat genioplasty. No long-term nerve dysfunction was noted. The osseous genioplasty is an effective procedure for correcting the chin deformity often seen in patients with craniofacial abnormalities. It is an easy technique to master and is associated with a low degree of morbidity.