Purpose: This article presents a novel manufacturing approach that integrates laser surface digitizing/scanning and computer-aided design (CAD) and manufacturing (CAM) to achieve automated fabrication of spatially and anatomically accurate extraoral facial prostheses. Materials and Methods: Topologic data of the patient’s face, including the site of deformity and the anatomy of a healthy “donor” organ, were acquired using laser surface digitizing. Two different CAD data manipulation techniques were developed to alleviate problems encountered in laser-digitized data sets. To reduce patient involvement, fitting of the prosthesis was conducted using a computer model of the patient’s face. Once finalized, rapid prototyping techniques were employed to fabricate a master pattern to cast the final prosthesis. Results: Three case studies involving different facial prostheses were conducted to evaluate the integrated manufacturing system. The results demonstrated the many advantages of the system for facial prosthesis production. Conclusion: With the new manufacturing approach, reduced patient discomfort, minimal dependence on the artistic skills of the prosthetist, and short turnaround times for prosthesis production can be expected. Int J Prosthodont 2003;16:435–441.