Surgical treatment of obstructive sleep apnea with abolition of obstructive apneas and hypopneas is possible by maxillomandibular advancement as our own results in 24 patients show. Maxilla and mandible must be advanced at least about 10 mm to secure success. Indication for maxillomandibular advancement should be restricted to patients with certain craniofacial disorders, which are of retrognathic dolichofacial type combined with pharyngeal narrowing. Before considering surgical treatment other possible contributing factors as for instance obesity should be eliminated, the more as nCPAP-therapy constitutes an effective conservative method. Despite our unchanged success rate after 1 year further polysomnographic follow-up control is essential to see what happens 5, 10 or 20 years after maxillomandibular advancement.