An unusual case involving an adult patient with marked facial and mandibular asymmetry secondary to congenital muscular torticollis is presented. The etiology and pathology of congenital muscular torticollis are reviewed. A team approach was used to correct this deformity. Procedures included a transcranial total orbital osteotomy, open distal myectomy of the sternocleidomastoid muscle, and a mandibular horizontal osteotomy.