This chapter outlines the Historical Development of Orthognathic Surgery, Protocol for Osteotomies, and Maxillary and Mandibular Osteotomy Procedures. The Historical Development is nicely given in a tabulated form. The step-by-step protocol is mentioned. Various osteotomy procedures for the correction of dentofacial deformities in mentioned in tabulated form. All the osteotomies in the mandibular body and ramus are explained with photographs and diagrams. Genioplasty is dealt with adequately. Similarly the maxillary osteotomy procedures; segmental, posterior and Le Fort I osteotomy with special mention about superior positioning of maxilla is also mentioned. Most of the dentofacial deformities along with actual patient\'s photographs are illustrated extensively covering pre surgical orthodontic phase and post operative results.