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Aesthetic outcomes were compared using the Whitaker classification.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>A total of 207 patients with nonsyndromic SC were treated with ES (n = 187) or CVR (n = 20). The ES group had a lower median operative duration (45 vs 195 minutes), length of stay (1 vs 3 days), and transfusion rate (2% vs 85%; p &lt; 0.0001). Median age at follow-up was 3.0 years (interquartile range [IQR] 2.5\u20134.5, ES) and 3.9 years (IQR 2\u20135, CVR; p = 0.12). In both groups, HCP gradually decreased during a 3-year follow-up (p = 0.282). CI Z-scores were initially more favorable in the ES group (p &lt; 0.05); 3 years following surgical intervention, Z-scores were equal between groups (p = 0.392). One nonsyndromic patient treated with ES (0.5%) demonstrated reossification and required secondary expansion. Most patients were Whitaker class I (99% of ES, 95% of CVR); 5% of CVR patients were class II and 1% of ES patients were class III. Four syndromic patients presented without clear evidence of a syndrome, were treated by ES, and subsequently required secondary expansion for raised intracranial pressure.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>ES is an effective treatment for nonsyndromic SC with comparable head growth, aesthetic outcomes, and less morbidity relative to CVR. 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