Aim: Orbital trauma is considered one of the most common maxillofacial traumas with functional and cosmetic impact to eye globe. The main objective is to establish a roadmap for the management of orbital floor fractures.Patients and Methods: One hundred and seventy-three patients were selected from the database of Mansoura University Hospitals with orbital floor fractures who were treated at the Department of Plastic & Reconstructive Surgery Department over past 4 years. Cases were retrospectively reviewed by preoperative clinical findings, management, surgical approaches, and sequelae. Authors evaluated timing and indication of surgical intervention, surgical outcomes, complications, and materials used for orbital reconstruction.Results: In total, there were (173) cases of orbital fractures with average age of (23.14) years. The leading cause of these fractures was motor traffic accident (64.7%). Pure blow-out fractures represent 25% of cases while fractures of inferior orbital rim alone were 45% of cases. Inferior orbital rim associated with orbital fractures were 30%. 57.2% of patients were managed surgically while 42.8% patients were managed conservatively. Conchal graft was used in 19 cases for floor reconstruction while 15 cases were managed by titanium mesh. In the follow-up, 10 patients still complain of enophthalmos, while 7 patients still complain of diplopia. Conclusions:Better postoperative results were presented in cases managed immediately or within two weeks surgically, A guideline for choice of effective protocol for management was developed.