In 2010, the National Institute for Occupational Safety and Health (NIOSH) published new digital head form models based on their recently updated fit-test panel. The new panel, based on the 2000 census to better represent the modern work force, created two additional sizes: Short/Wide and Long/Narrow. While collecting the anthropometric data that comprised the panel, additional three-dimensional data were collected on a subset of the subjects. Within each sizing category, five individuals three-dimensional data were used to create the new head form models. While NIOSH has recommended a switch to a five-size system for designing respirators, little has been done in assessing the potential benefits of this change. With commercially available elastomeric facepieces available in only three or four size systems, it was necessary to develop the facepieces to enable testing. This study aims to develop a method for designing and fabricating elastomeric facepieces tailored to the new head form designs for use in fit-testing studies. This novel method used computed tomography of a solid silicone facepiece and a number of computer-aided design programs (VolView, ParaView, MEGG3D, and RapidForm XOR) to develop a facepiece model to accommodate the Short/Wide head form. The generated model was given a physical form by means of three-dimensional printing using stereolithography (SLA). The printed model was then used to create a silicone mold from which elastomeric prototypes can be cast. The prototype facepieces were cast in two types of silicone for use in future fit-testing. © 2014 Copyright © JOEH, LLC.