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Background: Zygomatic complex fractures (ZMCF) are treated by various closed and open reduction procedures. The common goal, however, is to achieve three-dimensional stability of the fractured zygoma. Patients and Methods: All cases diagnosed with ZMCF were included in this study over a 10-year-period starting from December 2002 to December 2012 at Riyadh Dental Centre, King Saud Medical City-Riyadh, Saudi Arabia. Patient's gender, age, etiology, and type of treatment modality of the zygomatic bone fracture were retrieved and recorded. Data were stored and statistically analyzed using SPSS (ver. 16.0; SPSS Inc., Chicago, IL, USA). Results were presented as simple frequencies and percentages. Results: A total of 306 patients were diagnosed with ZMCF during the study period. There were 271 (88.6%) males and 35 (11.4%) females with a male-to-female ratio of 7.7:1. Age range of 21-30 years had the highest number of maxillofacial fracture. A total of 62 (20.3%) cases were treated by closed reduction while 235 (76.8%) cases were treated by open reduction and internal fixation using titanium miniplate (2.0 mm) and screws. Combination of treatment modalities was utilized in only 9 (2.9%) cases. Complications observed during the review period were palpable plate and screws in 26 (8.4%) patients. These palpable plates and screws, however, did not necessitate plate and screw removal from any of these patients. Conclusion: Most of the ZMCF were treated by open reduction and rigid internal fixation. Advances in imaging, surgical technique, and materials for fixation have allowed for improved functional and esthetic outcomes.