Sports participation produces a distinct spectrum of maxillofacial trauma with sport-, sex-, and age-specific patterns that differ from civilian mechanisms. Collegiate surveillance shows relatively low incidence but disproportionate time-loss, operative need, and cosmetic/functional sequelae. High-risk profiles cluster in grappling, stick/ball, and hand-ball sports, with nasal fractures, zygomaticomaxillary complex injuries, orbital blowouts, and condylar fractures predominating by mechanism. On-field priorities include airway protection, recognition of red-flag signs (septal hematoma, oculocardiac reflex, and extraocular entrapment), hemorrhage control, and evidence-based dental first aid. Diagnostic accuracy is maximized by dedicated maxillofacial CT with thin sections; CBCT reduces dose for osseous detail in stable settings, while ultrasound assists nasal fracture triage and reduction guidance. Management aligns with AO principles, emphasizing anatomic reduction, stable fixation, minimally invasive approaches, and early functional rehabilitation. Indications for orbital repair and condylar ORIF are highlighted. Preventive strategies—custom mouthguards, full-face shields, helmet standards, and pre-participation oral screening—lower dentoalveolar and facial injury risk and enable safer, earlier return-to-play. A structured, criteria-based RTP framework integrates clinical consolidation, functional readiness, protective equipment, and graded exposure. This chapter synthesizes epidemiology, mechanisms, imaging pathways, acute care, surgical decision-making, prevention, and rehabilitation tailored to athletes.