AbstractObjective:We report a case of infection against a background of pre-existing cranial fasciitis.Method:Case report and review of world literature on cranial fasciitis.Results:Cranial fasciitis of childhood is a benign condition and a rare variant of nodular fasciitis. We present the case of a 10-week-old infant with symptoms and signs consistent with a subperiosteal abscess complicating acute mastoiditis. Subsequent findings showed this to be an infection against a background of pre-existing cranial fasciitis.Conclusion:To our knowledge, this is the first such reported case in the literature. Knowledge of the distinctive histopathological features, coupled with an awareness of the condition, are crucial to establishing a definitive diagnosis of cranial fasciitis and, in turn, to instituting appropriate management. The aetiopathogenesis of the condition remains unclear.