OBJECTIVE: Assess/Managementof Airway of Major Maxillofacial Infections. METHOD: Retrospective study of 50 patients presenting to MWRH with MMI between January 1998 to July 2003. RESULTS:The population included 50(25 males,25 females),mean age 23(3-58)years.Referral sources were as follows:15(30%)medical practitioners,14(28%)dentists,15(30%)casualty,6(12%)inhospital. 23(46%) had prior treatment with oral antibiotics.No patient reported immunosuppressive illness.Infections were odontogenic in 49(98%) and cutaneous in 1(2%).All patients had plain radiographic examination,12 also had computerised tomography.The following intubation techniques were used: laryngeal mask 28(56%),orotracheal 13(26%),fibreoptic 7(14%)(3 oral,4 nasal),blind nasal 2(4%).No patients required a surgical airway.One patient was admitted to the Intensive Care Unit.Drainage was achieved via an extraoral and intraoral route.Penrose drains were placed in 31(62%).5(10%) patients had positive bacteriology cultures.The most commonly used antibiotic combination was Metronidazole and Augmentin intravenously ,in 26(52%) of the patients.Organisms cultured were as follows: a haemolytic strep 5, b haemolytic strep 2, bacteroides fragilis 2, provetella melaninogenicus 1,staphylococcus 1. The mean pre and postoperative hospital stay was 1.7(0-8) and 4.3(1-11) days respectively.All patients recovered uneventfully,with a mean followup of 55(10-180) days. CONCLUSION:MMI are largely odontogenic in origin.The emperic choice of antibioticc in critical in the patient because of a high percentage of negative cultures 45(90%).