1. INTRODUCTION Fractures of the midface pose a significant medical problem as for his or her complexity, frequency and their socio-economic impact. Inter disciplinary approaches and up-to-date diagnostic and surgical techniques provide favorable results in the majority of cases though. Traffic accidents are the leading cause and male adults in their thirties are affected most often. Treatment algorithms for nasal fractures, maxillary and zygoma fractures are widely prescribed whereas trauma to the sinus and therefore the orbital apex are matter of current debate. As for the fractures of the sinus a robust tendency towards minimized approaches are often seen. Obliteration and cranialization seem to decrease in numbers. Some critical remarks in terms of high dose methyl prednisolone therapy for traumatic optic nerve injury seem to be appropriate. Intraoperative cone beam radiographs and pre shaped titanium mesh implants for orbital reconstruction are new techniques and essential aspects in midface traumatology. Fractures of the anterior skull base with cerebrospinal fluid leaks show very promising results in endonasal endoscopic repair. The main focus is placed on bony injuries. Lesions of the soft tissue are mentioned only if they are important for the respective pattern of injury. Of course, it is very important to treat them appropriately because even in cases of perfectly reconstructed bony skeleton, scars may lead to deformities and dysfunctions that can only be corrected secondarily with significant difficulties [1], [2]. Trauma of the midface regularly lead to lesions of soft tissue, teeth, and bony structures of the skull including the maxilla, the zygomatic bone, the naso-orbital and naso-ethmoid (NOE) complex as well as supraorbital structures. Not rarely, those lesions of the midface are combined with injuries of other parts of the body [3]. Patients with midfacial fractures who do not undergo successful or appropriate treatment may suffer from significant long-term consequences such as disfiguring scars, bony deformities, or even loss of vision [4]. Relevant emotional and psychological problems may result from trauma[5],[6]. The successful treatment and rehabilitation of patients with lesions of the midface requires a profound knowledge of the anatomy, fractures, and techniques of osteosynthesis. Additionally, special knowledge in the field of occlusion, physiology of the eye, and skull base surgery are essential.