Pearls and Other Issues • Existing evidence regarding management of ZMC fractures is relatively low quality resulting in variation in management patterns; however, attention to form and function remains crucial when evaluating and repairing such fractures. • Treatment options of ZMC fractures include observation, closed reduction, and ORIF depending on the severity of the fractures.• Use the least number of incisions and fixation points as possible to achieve a stable reduction and fixation. • There should be a low threshold for consulting ophthalmology to rule out orbital injury. • There is no compelling evidence for routine antibiotic use when treating zygomatic fractures.