BACKGROUND: Maxillofacial trauma represents a significant challenge in emergency medicine, requiring both diagnostic accuracy and prompt intervention while balancing immediate life-saving interventions with preservation of function and aesthetics. The complex anatomy of this region, with its proximity to critical structures, demands a thorough understanding of assessment and management principles. This narrative review aims to provide evidence-based guidelines for emergency physicians managing maxillofacial trauma, with particular emphasis on early recognition of critical injuries, airway management strategies, and special population considerations. METHODS: A narrative review was conducted via a comprehensive literature search of the PubMed and Scopus databases, which focused on maxillofacial trauma management in emergency settings. Articles were selected based on relevance to clinical practice, methodological quality, and current management guidelines. The review synthesized evidence from multiple study types, including original research, systematic reviews, and clinical practice guidelines, to provide practical guidance for emergency physicians. RESULTS: Initial assessment following Advanced Trauma Life Support (ATLS) principles is crucial, with airway management being a primary concern due to the risk of dynamic obstruction. Critical time-sensitive emergencies include orbital compartment syndrome, trapdoor fractures (in pediatric patients), and facial nerve injuries. Computed tomography (CT) imaging remains the gold standard for diagnosis. Special considerations are required for pediatric patients, who present unique anatomical challenges and injury patterns, and for elderly patients, who often have complex medical comorbidities and increased complication risks. Management strategies range from conservative treatment to urgent surgical intervention, with decisions based on the injury pattern and associated complications. CONCLUSION: Emergency physicians must maintain a structured yet flexible approach to maxillofacial trauma, focusing on early recognition of critical injuries, appropriate airway management, and timely specialist consultation. Understanding injury patterns and their potential complications allows for effective risk stratification and treatment planning, ultimately improving patient outcomes.