Sublingual hematoma is a serious complication associated with anterior mandible surgery. It presents considerable risk due to the potential for airway obstruction, which can be life-threatening and necessitates prompt diagnosis and intervention. This case report describes the occurrence of sublingual hematoma following mandibular midline osteotomy and the subsequent management of this condition. Mandibular midline osteotomy is performed to correct skeletal or dental discrepancies in the transverse plane. Sublingual hematoma as a complication of a midline osteotomy has not been previously documented in the literature. This article provides a comprehensive review of the various etiologies associated with sublingual hematoma, along with its management modalities.