OBJECTIVE To evaluate the effectiveness of image-guided navigation on open reduction and orbital floor reconstruction as treatment for zygomatic-orbital-maxillary complex fractures. METHODS Six patients with zygomatic-orbital-maxillary complex fractures were enrolled in the present study. With preoperative planning and 3-dimensional simulation, the normal anatomic structures of the deformed area were recreated by superimposing and comparing the unaffected side with the affected side. The position of dislocated bone for reduction was defined, and surgical simulation was performed. All patients underwent open reduction and orbital floor reconstruction under the guidance of the navigation system. RESULTS A fairly accurate match between the intraoperative anatomy and the computed tomography images was achieved through registration, with a systematic error of 1-mm difference. With guidance of the navigation system, open reduction of zygomatic-orbital-maxillary complex fractures and orbital floor reconstruction were performed in all cases. The reduction was checked by postoperative computed tomography scans, with a good match with preoperative planning noted. The maximal deviation between the reduction and preoperative planning was less than 2 mm. The symptoms associated with the orbital floor defects were eliminated, and the postoperative facial appearance of the patients was clearly improved. CONCLUSIONS Navigation-guided open reduction of zygomatic-orbital-maxillary complex fractures with orbital floor reconstruction can be regarded as a valuable treatment option for this potentially complicated procedure.