Introduction Craniofacial surgery in children must account for region-specific skeletal growth, differential suture behaviour, and prolonged remodelling of the facial skeleton. Surgical timing has significant implications for long-term craniofacial development, occlusion, and facial symmetry, and inappropriate timing may result in predictable secondary deformity requiring complex revision. Purpose To present an anatomically structured, growth-based framework to guide the timing of craniofacial intervention in the paediatric population. Methods A focused narrative review of craniofacial and paediatric surgical literature was undertaken, examining normal and pathological craniofacial growth, behaviour of key growth centres, and outcomes associated with early versus delayed intervention. Evidence was synthesised into timing principles organised by anatomical region, including the cranial vault, orbit, midface, and mandible. Results Craniofacial growth is region-specific and non-linear. Early intervention is supported for cranial vault pathology, where rapid brain-driven growth permits effective remodelling and lower perioperative morbidity. Orbital intervention during growth should be selective and reserved for threats to vision or globe integrity. In contrast, definitive midface and mandibular procedures involve active growth centres and are associated with relapse and secondary deformity when performed too early. These regions generally benefit from delayed or staged correction, with definitive reconstruction closer to skeletal maturity. Across regions, timing decisions must balance functional necessity against predictable growth-related sequelae. Conclusion Optimal timing of craniofacial intervention in children requires an anatomical understanding of regional growth behaviour rather than a uniform age-based approach. A growth-aware, indication-driven framework supports durable functional and aesthetic outcomes while minimising iatrogenic deformity.