The primary objective of this study was to evaluate morbidity associated with facial translocation approaches for skull base and results of various technical modifications. Forty consecutive patients who underwent facial translocation approaches for accessing skull base tumors from July 2005 to June 2010 were included in this study. There were 25 patients who underwent standard facial translocation, 4 patients medial mini, and 11 patients underwent extended facial translocation. Thirteen patients had benign disease and 27 patients had malignant disease. Resection was R0 in 36 and R1 in 4 patients. Most patients had acceptable cosmetic results. None of the patients had problems related to occlusion or speech and swallowing. The commonest complication observed was nasal crusting in 16 patients. Grade 2 trismus and exposure of mini plate was seen in three patients. Two patients developed necrosis of translocated bone. Three patients developed palatal fistula before modification of palatal incision. Facial translocation provides a satisfactory access for adequate clearance of skull base tumors with satisfactory aesthetic and functional results. With modifications of the surgical technique and implementation of new surgical tools, the morbidity of facial translocation approaches will continue to decrease.KEYWORDS: Facial translocation approach, morbidity, skull base, infratemporal fossa Tumors located within the nasopharynx, posterior maxilla, infratemporal fossa, and central skull base pose a significant challenge with regard to access and exposure. Successful treatment of these tumors depends upon adequacy of exposure and complete resection of the lesion. Several approaches such as the facial translocation, 1 the maxillary swing, 2 the infratemporal fossa, 3 the transpalatal 4 as well as the transmandibular 5 and endoscopic approaches 6 have been described to provide exposure for resection of these tumors. Most of these approaches are traditionally associated with significant functional and cosmetic consequences.