Aims: The aim of this study was to compare the outcomes of intra-oral and extra-oral approaches to mandibular angle fractures. Material and methods: A Retrospective study was conducted in the Department of Dentistry, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India from April 2019 to September 2019. Total 120 Patients with angle fracture that required open reduction and internal fixation were include in this study. All the Patients were reviewed for age, gender, presence of other fractures, type of surgical approach, number of plates, OT time, which was calculated from the beginning of the incision till the closure. Length of admission and complications such as malocclusion, non- union, re-operation, post-op infection, neurosensory deficit, facial nerve injury, implant retrieval, scarring and wound dehiscence were also studied. Results: There were a total of 120 patients with mandibular angle fracture who underwent open reduction and internal fixation, 60(50%) of them were treated intra-orally and the remaining 60 (50%) of them extra orally. Male patients formed the majority of mandibular angle fractures (91.67%) in extra-oral group and 95% in intra-oral approaches (p=0.81). the mean age of patients in intra-oral group was 33.28 years and 36.77 years in the other group with a standard deviation of 11.87 and 12.95 respectively. The mean operating room time for intra-oral approach was 95.93 minutes when compared to 103.06 minutes for extra-oral approach with a p value of 0.58. Malocclusion was seen in 15% of extra-oral cases and 18.33% of intra-oral approach patients, with a p value of 0.77. Non union was not seen in any of the cases. Re-surgery was performed in 13.33% of the extra-oral cases and none in the intra-oral group. (p value-0.32). Post-op infection was observed in 11.67% of intra-oral cases and 26.67% of extra-oral cases with a p value of 0.28. Neurosensory disturbance occurred in 15% of extra-oral cases and 31.67% of intra-oral cases (p value-0.93). facial nerve injury occurred in 31.67% of extra oral cases and none in the intra-oral group, p vale of 0.016 which is found to be significant. In the entire sample. Extra-oral scarring occurred in 35% of extra-oral cases and none of intra-oral cases (p value-0.011). Conclusion: we conclude the use of intraoral approach while clinically favorable with single miniplate along the superior border.