This chapter presents perioperative, anesthetic, behavioral, and dental considerations for patients with special needs in maxillofacial practice. It addresses autism spectrum and neurodiversity, intellectual disability, cerebral palsy and movement disorders, trisomies with emphasis on Down syndrome, spina bifida with latex-allergy pathways and neurogenic sequelae, and craniofacial syndromes affecting airway and resonance. Core themes include individualized sensory and communication planning, ethically sound consent frameworks with assent, proactive behavior supports, aspiration-risk mitigation, protection of cervical spine stability, sleep-disordered breathing and cardiopulmonary vigilance, latex-safe surgical pathways, prevention of pressure injury, and team-based airway strategies for syndromic craniofacial anatomy. The chapter integrates practical tactics for scheduling, positioning, pharmacologic premedication and sedation escalation, environmental modification, and long-term maintenance models that establish a continuous “dental home” and structured follow-up. The guidance prioritizes humane, safe, and equitable care, emphasizing predictable routines, caregiver partnership, and multidisciplinary coordination to reduce morbidity while enabling definitive oral and maxillofacial treatment.