The last five decades have seen decisive advances in orthognathic surgery in terms of surgical techniques and outcomes in the treatment of dysgnathic maxillo-facial malocclusion and deformities. However, despite brilliant technical innovations, the basic surgical principles have remained unchanged. The most common midface osteotomy techniques currently used to correct growth-related sagittal, vertical, and transverse deviations, as in syndromal and non-syndromal maldevelopments, in various modifications, involve Le Fort osteotomies in the Le Fort I, II, and III levels of the jaws. Segmented and multi-segmented maxillae are an option for transversal and vertical corrections. In the vast majority of midface osteotomies, the Le Fort I osteotomy is used. It is a safe and versatile procedure when performed correctly. Only the Le Fort I osteotomy and its variations can be usefully applied in simultaneous bimaxillary corrections.