Objective To investigate the clinical application of self-cranial bone powder in one stage cranioplasty．Methods From October 1999 to December 2002,self-cranial bone powder and medical adhesive were used to repair the skull defect, for one stage cranioplasty, caused by operations on cranium in 128 casesof severe dangerous craniocerebral injury, acute intracranial hematome, sick skull and intracranial tumor．The bone growth was observed by CT or X-ray examination 3-24 months after replantation of cranioplasty．Results The decompression and cranioplasty were performed simultaneously, the time prolonged 5-10 minutes than that of routine, the appearance of repaired cranial bone was normal, without concavity and convexity. After 12 months of operation, the replanted bone merged with the normal bone completely, with normal appearance. The operation successful rate was 96.1%(123/125) without any complication. Only fivecases were not better in growing because of less bone powder, but withoutcerebral pulse and defective syndrome. All the cases did not need secondary cranioplasty．Conclusion The effect of cranioplasty with self-cranial bone powder effect is good in taking shape. This new method can avoid the traditional secondary cranioplasty for skull defect and complications．