Idiopathic condylar resorption almost exclusively affects women. Its exact etiology and pathogenesis remain unclear. It has been associated with rheumatoid arthritis, temporomandibular joint internal derangement, condylar fractures, connective tissue or autoimmune diseases, orthodontic treatment, and orthognathic surgery. In most cases, however, there is no identifiable precipitating event, hence the term "idiopathic condylar resorption." The female predisposition to this condition may be attributed to the influence of estrogen and prolactin on the bone response. Treatment of idiopathic condylar resorption is controversial. Condylectomy and reconstruction with costochondral graft offer definitive management of active idiopathic condylar resorption.