Purpose of review <p>This review summarizes current trends in facial trauma epidemiology, management, and costs in the United States. It then focuses on interfacility transfer patterns and drivers of secondary overtriage. Finally, it proposes strategies for reducing unnecessary transfers.</p> Recent findings <p>Most facial fractures can be managed non-operatively or on an outpatient basis. However, patients with maxillofacial injuries are frequently transferred to a higher level of care and subsequently discharged at the receiving hospital without intervention. These transfers burden tertiary centers’ resources and increase healthcare expenditures. Secondary overtriage may be due to inadequate access to facial trauma services, limited availability of maxillofacial surgeons participating in facial trauma call, and poor reimbursement.</p> Summary <p>Secondary overtriage of facial trauma patients is prevalent across the United States, creating inefficiencies in resource utilization. Education for emergency medicine providers, implementation of telemedicine, and increased reimbursement may promote more equitable and efficient management of facial trauma.</p>