Objective To investigate the value of three-dimensional plastic titanium mesh cranioplasty in the repair of skull defects. Methods The data of 45 patients who underwent titanium mesh repair for craniocerebral injury in our hospital from July 2018 to July 2020 were collected. The patients were assigned to the observation group（n=24） and control group（n=21） following different surgical methods. The operation time

intraoperative blood loss

length of hospital stay

number of titanium nails used

National Institutes of Health Stroke Scale（NIHSS） score

and cosmetic satisfaction at 3 months after operation were compared between the two groups. Results The operation time and length of hospital stay in the observation group were significantly shorter than those in the control group

and the intraoperative blood loss and the number of titanium nails used in the observation group were less than those in the control group

with statistically significant differences（all P<0.05）.Before the operation

there was no significant difference in the NIHSS score between the two groups（P>0.05）.The NIHSS score in the two groups 1 year after the operation was significantly lower than that before the operation

and the observation group was significantly lower than the control group

and the difference was statistically significant（all P<0.05）.The cosmetic satisfaction rate 3 months after the operation in the observation group was 100.0%

which was higher than that in the control group（57.1%）

and the difference was statistically significant（P<0.05）.Conclusion Three-dimensional plastic titanium mesh cranioplasty in the repair of skull defects has the advantages of a short operation time

less intraoperative blood loss

less use of titanium nails

conducive to the improvement of postoperative neurological function

and can obtain higher cosmetic satisfaction.These advantages hold promise for a wider application of this technique clinically.