Midfacial resection procedures underwent significant improvements over the last years with the advent of virtual surgical planning and image-guided surgery. The possibility of establishing a predicted resection in relation to tumor distance in the virtual model has been demonstrated to lead to a successful rate of resection margin control. The evolution of virtual planning software, allowing to trace curved resections instead of linear planes only, translated in a more reliable representation of virtual resections, which can be converted into operative coordinates using image-guided surgery techniques, of which navigation of virtual planning is the mainstay. Experimental applications of mixed and augmented reality are highly promising to bring in the operator’s visual field the computer planning, enhancing surgical perception and confidence. Moreover, the importance of coupling a resection planning with a reconstructive procedure enables to optimize resection margins for the future flap insetting or implant positioning. Last, the possibility to entirely simulate endoscopic procedures in virtual reality greatly impacts the increasing endoscopic treatment of sinonasal malignancies. This chapter provides a comprehensive overview of the most innovative approaches to midfacial resection with a tailored application of virtual planning, image-guided surgery and 3D printing.