Objective: To assess the closure of pediatric craniostomy incisions with the use of cyanoacrylate adhesive in comparison with simple monofilament suture closure at the Neurosurgery unit of the Lagos University Teaching Hospital (L.U.T.H.) Materials and methods: This was a prospective hospital based study involving 46 patients carried out over an 18 month period. Patients who met the inclusion criteria for the study were randomized into either the test (tissue glue) group or the control (suture) group to meet the study sample size. An informed consent was obtained from the caregiver of each patient. The intraoperative time of wound closure was recorded for each participant. Wound complications were assessed on the 4th and 7th post-operative days, for both groups while the scar cosmesis was assessed using the Hollander Wound Evaluation Scale (HWES) and the Visual Analogue Scale (VAS) at 4th week post-discharge, during follow up outpatient clinic visit. Results: The mean duration of wound closure was 2.36 minutes for the suture group, whereas that for the tissue glue group was 3.53 minutes. This difference is statistically significant (p<0.001). Both study groups had equal proportions of cumulative wound complications at 52.2% in each group. Though, there was a higher proportion having delayed complications (hypertrophic scar, pseudomeningocele, stitch abscess) among the suture group (21.7%) compared with the glue group (4.3%), these differences were not statistically significant. The only case of wound infection which yielded a culture growth of staphylococcus aureus was in the suture group. Using the wound healing satisfaction scale, The Visual Analogue Scale, (VAS), assessed by the care givers, where 0 means highly satisfactory and 10 means dis-satisfaction, the mean VAS score for the suture group was 2.7 (±2.5) whereas that for the tissue glue group was 3.1 (±3.4). This difference in rating between the two groups was not statistically significant (p=0.123). With the Hollander Wound Evaluation Scale (HWES), the highest aggregate score showing satisfactory healing is 6. A higher proportion of study participants attained this score in the suture group when compared to the tissue glue group; 69.6% versus 39.1%. This difference was not statistically significant (p=0.135). However, there was a statistically significant difference in the mean scores between the two groups (5.3 ± 1.4 for the suture group versus 4.7 ± 1.6 for the tissue glue group; p=.0.049). Conclusion: Although the use of tissue glue is a relatively new wound closure technique in our setting, the outcome measures assessed in this study showed that the use of tissue glue did not show any overt advantage over the use of monofilament suture in the closure of paediatric craniostomy incision.