Crown (or vertex) hair restoration represents one of the most technically challenging areas to reconstruct for a host of reasons. The natural whorl, or spiral, pattern of hair in the crown region of the scalp must be meticulously recreated in which every hair angle matches the existing hair and blends seamlessly toward the outer fringes to the sides and as the hair transitions forward to the midscalp (vertex transition point). The hair also must be tightly interlocked to achieve the greatest amount of hair density, especially in the upper arc of hair where the hair cascades over the other hairs in the crown. Judicious graft selection and placement will afford the optimal result without wastage of follicular grafts.