Summary Many treatment modalities are available for mitigation of pain and dysfunction of the habitually dislocating temporomandibular joint. In most cases, more conservative methods provide only temporary alleviation of symptoms, and recurrence is common. Surgical intervention has generally been considered the more effective definitive treatment. No matter which surgical intervention is undertaken, it should be realized that postoperative scarring probably provides a significant portion of the surgical benefit. Evidence suggests that immobilizing the joint after any surgical procedure will result in fibrosis, which may make assessment of efficacy of the actual surgical procedure difficult. Some authors have claimed that signs of recurrence were related to early mobilization of the joint and that MMF is always indicated. True comparisons of the reported treatment modalities are difficult because of differing periods of follow-up and different definitions of success (Table I). Several factors should suggest caution before using some of the procedures reviewed here. Studies that do not report length of follow-up, or that report follow-up less than 1 year, should not be viewed as other than pilot data. Likewise, series incorporating fewer than 25 patients should be viewed with caution. Techniques reported in only 1 series with a single clinician may not achieve the same results when applied by others. The likelihood of permanent adverse sequelae or need for repeat surgery should weigh heavily in the decision to use any treatment modality. With these considerations in mind, we believe that certain treatment modalities should be avoided. Sclerosing agents, in general, have an unacceptably low rate of success and should not be considered permanent treatment. The addition of MMF has not improved outcomes significantly. Capsular plications have been reported too rarely to be considered mainstream treatment, as have physical therapy and botulinum toxin injection. Zygomatic arch downfracture, with or without grafting, appears to offer a high degree of resolution of dislocation, although the number of reported cases is less than half that of eminectomy. With an impressive success rate, we believe that eminectomy offers the best chance for long-term resolution of recurrent dislocation, provided that care is taken to completely remove the most medial portion of the eminence. Although additional studies may yield improved therapeutic techniques, it appears that surgical intervention currently remains the mainstay in management of this uncommon clinical entity.