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Zygomatic bone and arch fractures are among the most common facial fractures treated by facial plastic surgeons. Controversy still remains regarding the optimal management of these fractures. Computed tomographic scanning (including three-dimensional reconstruction) represent a fundamental tool for diagnosis and treatment planning of zygomatic fractures. Main indications for treatment are functional impairment, cosmetic deformity, or both. Fracture reduction can be performed through an open or closed approach depending on the amount of exposure necessary to achieve accurate reduction. The common goal among all treatment plans is the exact three-dimensional restoration of the disturbed anatomy and function while minimizing complications.