Abstract: A guided osteotome for use in the harvesting of bone graft material for craniofacial plastic surgery includes an instrument body having a blade on the instrument body with a cutting edge for cutting through a layer of selected bone tissue suitable for grafting. The blade includes a flattened portion adjacent the cutting edge and lateral guides positioned on the blade on opposite edge portions of the cutting edge. The guides define the depth of cut of the cutting edge and include one or more bearing surfaces which track upon the surface of a patient's skull during the bone graft harvesting operation.