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Content: A tight left sternocleidomastoid muscle and/or opposite neck muscle weakness prevents the head from turning fully to the left and results in a tendency to look to the right. An infant with a left CMT presents with right positional plagiocephaly. Facial symmetry is worsened by the pull of the SCM on the side of the face, creating flattening of the ipsilateral forhead, cheek and face. Children may also present with a positional torticollis, with a head turning preference and/or head tilt. Active and passive neck range of motion and head tilt should be checked in all patients with positional plagiocephaly to rule out CMT as the cause of the plagiocephaly. Children with CMT should be referred to physiotherapy early to restore cervical range of movement, correct a head tilt and prevent positional plagiocephaly. Unilateral Lambdoid Synostosisor premature fusion of one lambdoid suture may also cause occipital flattening. However, lambdoid synostosis is very rare, occurring in 1 in 150,000 newborn children. The diagnosis is made by correlation of the occipital flattening with retractionof the ear and forehead on the same side due to the generalized growth restriction of the fused suture. This is unlike positional plagiocephaly where the ear is displaced anteriorly.