OBJECTIVE We sought to study the incidence and causes of removal of osteosynthesis miniplates (plates) in oral and maxillofacial surgery in a single unit over a 13-month period and to identify factors associated with plate removal. METHODS We conducted a retrospective study of 172 patients attending the Department of Oral and Maxillofacial Surgery, University Hospital Birmingham, between November 1, 1998, and November 30, 1999, in whom maxillofacial osteosynthesis plates were inserted or removed. Not all patients who had plates removed had them inserted within the same time frame. RESULTS During a period of 13 months (November 1, 1998, through November 30, 1999), 308 plates were inserted into 153 patients. During the same period, 51 plates were removed from 28 patients, of whom 9 underwent plate insertion and subsequent removal of 25 plates within the time period of the study. Thirty-four (67%) of the plates removed from 20 patients were symptomatic. Infection was the most common cause for removal, occurring in 14 patients (50% of patients who had plates removed) and accounting for 22 plates (43% of plates removed). Symptoms relating to plates necessitating removal occurred in the first year after insertion in 15 patients (53%), accounting for 21 plates. CONCLUSIONS Our experience with the removal of miniplates is comparable with that of previous studies. Plate-related problems leading to removal are more likely to occur within the first year after insertion.