ObjectivesThe purpose of this study was to do a retrospective analysis of patients with zygomatic fractures who were treated at the Department of Maxillofacial Surgery, Regional University Hospital of Perugia, Italy, between 2016 and 2023.Materials and MethodsPatients were evaluated based on various parameters including age, sex, aetiology, symptoms, comorbidity, clinical findings, zygomatic fracture type, other facial fractures, treatment, waiting time before the operation, complications and sequelae. In the period described, we had 123 cases of zygomatic fractures requiring surgical intervention.ResultsAmong the patients, 101 were male (82.1%) and 22 were female (17.9%). The average age of the patients was 48.65 years (ranging from 7 to 94 years).The leading cause of these fractures was sports‐related injury (n = 32; 26.01%), and isolated zygomatic bone fractures were the most frequent (72.43%). The most common clinical signs and symptoms were pain, depression of the facial profile, difficulty in chewing, limitation of the buccal opening, difficulty in protrusion movements and mandibular lateralization. Ninety‐six per cent of patients underwent surgery under general anaesthesia, with open reduction and internal fixation.ConclusionsThe successful and effective management of zygomatic fractures requires a solid understanding of its anatomy, pathophysiology and related biomechanical structures and forces. The continuous research in epidemiology, aetiology, materials and techniques will further refine our treatments which are nowadays more and more customized according to the type of trauma.