This chapter focuses on surgical management of extensive vitiligo and offers tips for performing such surgeries. A patient of stable vitiligo may have a large area to be operated and may not have time for multiple sessions such as those coming from a foreign country, or those with a marriage in the offing. Taking up mega or gega sessions of nonculture epidermal suspension is safe and effective. Doing large areas in a single session is the best way to manage a patient having extensive vitiligo in minimum sessions. However case selection has to be done carefully and after thorough counseling. The process requires planning and dedicated team of dermatologists, anesthetist, OT nursing staff technicians, and post nursing care to make the procedure safe and comfortable for the patient. Preoperative counseling and informed consent, duration of anesthesia, donor-recipient ratio, cultured methods, special care with extensive punch grafting, etc. are also provided in this chapter.