Anesthetic cases of oral and maxillofacial surgery during the period 1976-1985 were reviewed. There was a total of 653 cases, and the most frequently performed operation in this series was open reduction of maxillofacial bone fracture (22.8%). Special clinical problems were encountered in the 72 cases (11.02%) who underwent surgery for osteoradionecrosis, because most of them suffered from trismus and stiff neck. Nasotracheal intubation was more commonly used (84.69%). Sixty six cases received tracheostomy since they suffered from serious trismus and/or severe maxillofacial fracture. The recently introduced method of induction using etomidate and fentanyl seemed effective in maintaining hemodynamic stability. In 147 cases (22.51%), the anesthesia lasted more than 4 hours. In 366 cases (56.04%), a local infiltration of the operation field was performed with 1:100,000 epinephrine. Of these, 76 cases developed cardiac arrhythmia, mainly VPC (ventricular premature contraction) 12 of whom had a history of preoperative cardiac arrhythmias. The incidence of preoperative medical disease was 10.27%, the most common being cardiovascular (32.84%) and respiratory (26.87%) disease. Complications occurred during anesthesia in 122 cases (18.69%) with a high incidence of cardiac arrhythmia (67.21%).