Purpose: To evaluate whether the use of virtual surgical planning (VSP) is associated with shorter operative time for total calvarial vault remodelling (TCVR) in patients with sagittal synostosis. Methodology: A prospective review was conducted of consecutive patients undergoing TCVR for sagittal synostosis by a single surgeon at a single centre between January 2024 and January 2025. Six patients met inclusion criteria, with a mean age at surgery of 1 year and 2 weeks. Patients were divided into two cohorts based on the pre-operative planning pathway. Three patients underwent VSP assisted TCVR, utilising a predesigned virtual model with patient specific cutting guides (Stryker and 3D Systems). Three patients underwent conventional TCVR using standard pre-operative planning without VSP. The primary outcome was total operative time, defined from skin incision to closure. Secondary observations included pre-operative planning requirements and procedural costs. Results: Mean operative time was 5 hours 3 minutes in the VSP group compared with 6 hours 45 minutes in the non-VSP group, a difference of 1 hour 42 minutes. While the use of VSP reduced operative time, it required significantly more pre-operative planning time involving multiple surgeons and engineers and was associated with higher direct costs. Conclusion: In this prospective review, VSP assisted TCVR for sagittal synostosis was associated with a meaningful reduction in operative time, at the expense of increased pre-operative planning time and cost.