OBJECTIVE To present and discuss the demographic and clinical aspects and the management of 44 cases of osteomas of the craniomaxillofacial region. METHODS A retrospective chart review was performed of all cases of osteoma diagnosed from 2000 through 2010. The data collected included age at diagnosis, gender, lesion location, presenting symptoms, type of osteoma, treatment, and outcomes. RESULTS Forty-two patients with 43 osteomas were diagnosed during the study period. Their mean age was 48 years. The male-to-female ratio was 0.4:1. Twenty-one patients were asymptomatic, whereas 10 patients complained about headache and neuralgia, and 11 patients presented with facial asymmetry. Only 21 symptomatic osteomas were surgically removed after histologic diagnosis, whereas for the asymptomatic lesions a careful follow-up was maintained. CONCLUSIONS The slow growth of osteomas allows a conservative attitude toward asymptomatic lesions. Thus, when surgery is performed, it is extremely important to plan a surgical approach that minimizes any damage to the adjacent structures.