Craniofacial resection surgery—the en bloc removal of tumors that straddle the anterior skull base and sinonasal complex—has evolved from a high-risk, last-resort procedure into a multidisciplinary cornerstone of skull-base oncology. This chapter synthesizes current principles and techniques that have enabled this transition. Surgical anatomy is reviewed with emphasis on vascular, dural, and orbital relationships critical to safe margins. This chapter outlines both endoscopic and combined approaches to resection of large complex sinonasal tumours, in an attempt to achieve disease-free margins and minimize morbidity.