Maxillofacial injuries are common during trauma and sub-condylar fractures are considered one of the most challenging fractures to manage due to esthetic and functional concern. Purpose: Assessment of facial nerve damage and stability of occlusion by retro-mandibular approach. This was a Prospective cross-sectional study at a secondary care hospital, Ministry of Health, Riyadh, Saudi Arabia during from August 2017 to July 2019. Patients and Methods: Fourteen patients with sub condylar fracture were operated with open reduction and internal fixation through retro mandibular approach. Inclusion criteria were patients above fifteen years old with disturbed occlusion and displaced fractured sub-condyle. Results: Efficacy was assessed based on occlusion stability and status of the facial nerve postoperatively All Patients with sub condylar fractures (n=14) were operated with retro-mandibular approach. Fourteen patients aged sixteen years and above including 12(85.7%) males and 2(14.3%) females, with left side 7 (42.9%), right side 7 (42.9%) and bilateral 2 (14.3%) involvement. The significant etiological factor was road traffic accident 8 (57.1%) followed by history of fall 2(14.3%). Immediate postoperative findings showed facial nerve weakness in 2(14.3%) patients [buccal branch 1(7.1%); marginal mandibular branch 1(7.1%)] and both fully recovered after three months. Postoperative occlusion was normal in 12 (85.7%) patients while it was temporarily disturbed in 2(14.3%) patients and it significantly improved by the final follow-up visit. Conclusion: On the basis of our clinical findings, we recommend the retro mandibular approach as it provides good visibility with less facial nerve damage risk.