Postoperative bone infections are uncommon yet highly morbid complications following cranial surgery. Limited vascularity of the bone flap and the presence of devitalized tissue promote the development of infection and hinder adequate penetration of systemic antibiotics. Early diagnosis is achieved through a combination of clinical evaluation, laboratory parameters, wound and tissue cultures, and advanced imaging techniques such as CT, MRI, and nuclear medicine studies. The cornerstone of treatment is complete removal of infected tissue, administration of targeted systemic antibiotic therapy, and surgical reconstruction when necessary. Adjunctive methods such as antibiotic-impregnated PMMA (polymethyl methacrylate), wash-in/wash-out irrigation systems, and hyperbaric oxygen therapy have been described in the literature; however, they are not part of standard treatment protocols and should be reserved for selected, complex cases. With appropriate surgical technique, effective infection control, and proper reconstructive strategies, favorable clinical outcomes can be achieved in postoperative cranial bone infections.