The most common suture fusion in Apert syndrome is bilateral coronal synostosis. Due to the difficulty in surgically repairing turribrachycephaly in a single-stage operation later in infancy, most craniofacial centers are now performing an early operation to prevent this progression. This chapter discusses early endoscopic strip craniectomy for the management of bilateral coronal craniosynostosis in the patient with Apert syndrome. It reviews the surgical technique and outcomes, and demonstrates that early endoscopic coronal strip craniectomies can offer a safe and effective alternative to other treatment options such as posterior distraction, and prevents the progression of turribrachycephaly. In many patients, it also offers the possibility of a single-stage repair. Additionally, this chapter discusses the relatively low cost and resource utilization of early endoscopic management relative to open surgery options. For these reasons, the authors suggest the widespread utility of endoscopic management for Apert care, including in low- and middle-income countries.