OBJECTIVE To describe the patterns of facial fractures presenting to a tertiary referral centre in New Zealand, and to identify risk indicators for maxillofacial trauma. METHODS Clinical records of 2527 patients referred to a tertiary base hospital for the treatment of maxillofacial fractures from 1989 to 2000 were retrospectively analysed. Age, sex, ethnicity, cause of injury, anatomic location of facial fractures, alcohol involvement, and treatment received were recorded. RESULTS The number of facial fractures treated by the Maxillofacial Unit at Waikato Hospital annually almost doubled over the 12-year study period (1989 to 2000). Eighty percent of those presenting with maxillofacial injuries were male, and 40% were aged between 15 and 24 years. Interpersonal violence and road traffic accidents were the most frequent causes of facial fractures. Alcohol consumption was associated with just over one-third of all cases, and was strongly associated with interpersonal violence. CONCLUSIONS Presentation of patients with facial fractures at the Maxillofacial and Oral Surgery Unit at Waikato Hospital almost doubled over the 12 years. Risk indicators for presentation with a maxillofacial fracture included male gender, alcohol consumption, and interpersonal violence. There is an urgent need for appropriate health promotion to reduce interpersonal violence.