Surgical interventions are infrequently required in the management of patients suffering from temporomandibular disorders [TMD] other than in specific circumstances. When there is an indication for a surgical intervention, it will have ideally been after the patient has been diagnosed and managed by a multi-disciplinary team. This team will have employed a variety of conservative and non-invasive modalities. This is to say that the oral and maxillofacial surgeon sits within a broad-based multi-disciplinary clinic. The number of surgical procedures has significantly reduced over the past few years as better, more targeted surgical interventions for specific TMD sub-group diagnoses become the norm. This, in turn, has led to decreased frequency of repeated surgery, which can have poorer outcomes. This chapter sets out different presentations/sub-types of TMD that might need and benefit from surgery, and it describes the surgical interventions that are appropriate to them. It will be essential reading for the junior grades of OMFS and will be of interest to general dentists who manage and/or refer their TMD patients.