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The stability and predictability of Orthognathic surgical procedures varies by the direction of surgical movement, the type of fixation, and the surgical technique employed, largely in that order of importance. This review discusses about the various keystones that are required to select, perform and manage Orthognathic surgery. The outcome of an Orthognathic surgery is influenced by numerous factors both internal and external factors. In spite of recent advances in the field of surgery, Orthoganthic surgeries are still a challenge because, their treatment goals are predominantly dependent upon the precision of the operating surgeon. Function, esthetics and stability are the goals that a surgeon strives to achieve during an Orthognathic procedure. Proper patient selection, treatment planning and postsurgical care are required for a successful results. Surgeon must also take into account, the patient's complaint and provide them with a realistic fact based assurances on results. This review would highlight the various cogs in the Orthognathic surgery working in harmony to achieve desired results. The article emphasis about the principles, preoperative analysis for surgical execution and sequence of the treatment to be done.