 Computer aided design and manufacturing, CAD slash CAM, technology today is the standard in manufacturing industry. The application of the CAD slash CAM technology, together with the emerging 3D medical images based virtual surgical planning, VSP, technology to craniomaxillofacial reconstruction has been gaining increasing attention to reconstructive surgeons. This article illustrates the components, system and clinical management of the VSP and CAD slash CAM technology including data acquisition, virtual surgical and treatment planning, individual implant design and fabrication and outcome assessment. It focuses primarily on the technical aspects of the VSP and CAD slash CAM system to improve the predictability of the planning and outcome. This article was authored by Lin Pingzhao, Praveen Kapatell and Mimi Schoen.