Major maxillofacial injuries are common in patients with multiple injuries and may be life-threatening due to obstruction of airways and bleeding. The initial treatment is to secure and maintain a free passage of air and to control bleeding. The extent of the injury is assessed after careful clinical examination and CT scanning of the facial skeleton. Treatment consists of suturing soft tissue, and reduction and fixation of fractures. Open reduction and stable fixation using lag screws, microplates and miniplates are recommended. The best results are obtained by operative treatment of major maxillofacial injuries as early as possible.