Premature closure of the sagittal suture is thought to be fundamental to the etiopathology for the disease process called sagittal craniosynostosis. This process traditionally results in a well-known skull malformation termed dolichocephaly. Over recent decades, some authors have questioned the suture as the primary driving force for this pathology. This is a retrospective cases series of 4 patients from 2011 to 2012 who presented to the Yale Craniofacial Clinic for evaluation of dolichocephaly. The 4 children, 3 boys and 1 girl, had physical examinations and cranial indices concerning for sagittal craniosynostosis; however, subsequent computed tomographic imaging revealed sagittal suture patency. This series adds to a growing body of literature, which describes abnormal head shapes not attributable to overt suture pathology.