Cranioplasy can be performed with a range of materials such as auto-polymerizing methyl-methacrylate, heat polymerizing methyl-methacrylate, high temperature vulcanizing medical grade silicone and metal. Conventional as well as advanced techniques such as virtual planning and printing have been used for fabrication of cranial prosthesis. Every material has its own advantages as well as drawbacks. High temperature vulcanizing medical grade silicone is used for fabrication of cranioplasty prosthesis due to certain beneficial properties of the material. High temperature vulcanizing medical grade silicone cranial implant leads to better adaptation with the bone adjacent to cranial defect in comparison to acrylic and metal cranial prosthesis. In this article the key features of the technique for fabrication of cranial implant prosthesis with high temperature vulcanizing high temperature vulcanizing medical grade silicone material have been discussed.