The quality of care for craniofacial malformations is thought to be improved through benchmarking. The benchmarking process identifies the best practice within the participating centers and leads to new protocols and guidelines, which are implemented by the participants. It also allows for comparison of outcome between the various centers. Among the International Society for Craniofacial Surgery (ISCFS) a first international pilot study was undertaken on benchmarking for craniosynostosis, and a preliminary set of recommendations is made. A controlled number of centers including multidisciplinary teams was a prerequisite. A minimum number of patients operated per year seemed to be a valid parameter for decreasing morbidity.