This report concerns a 20-month-old boy, born at 31 weeks of gestation, being followed in the paediatric clinic because of prematurity. He was developing appropriately for his age and his head circumference was growing steadily (between the 75th and 90th centile), with weight and height on the 25th centile. An x-ray of his skull was performed at this stage because of his head shape, which was long and narrow (scaphocephalic)—in itself suggestive of sagittal synostosis. The x-ray confirmed the diagnosis. He was referred to a regional neurosurgical unit for further management. He had a successful surgical correction without major problems. It is to be emphasised that there is a higher morbidity and mortality if reconstructive surgery is not carried out at an early age, and therefore early diagnosis is vital in this congenital condition.