Maxillofacial trauma encompasses a wide range of complex injuries. This chapter confines itself to those involving the sinonasal structures. Facial fractures may occur following blunt or penetrating trauma. Multidetector computed tomography is the modality of choice for delineating the complete extent of injury as well as the associated complications. It has currently replaced plain radiographs in this setting. This chapter covers the classification, anatomy, specific fractures, complications of sinus fractures, and illustrative case in a reporting format. Sinonasal fractures may be part of more complex facial fractures involving multiple buttresses (Le Fort fractures); or occur as less severe isolated injuries. Complex facial injuries include Le Fort fractures, nasoorbitoethmoid (NOE) fractures, and zygomaticomaxillary complex fractures.