Background. During the past few decades, orthognathic surgery has become routine in oral and maxillofacial surgery. As these surgical interventions are elective, the goal is a low complication rate. The aim of this study was to analyze the intraoperative and postoperative complications after orthognathic surgery without considering orthodontic relapse. Patients and methods. The medical files of 507 patients were reviewed who had been treated in the department of oral maxillofacial surgery at the Martin-Luther-Universität in Halle-Wittenberg during a period of 51 years. The indication for orthognathic surgery was mandibular hyperplasia in 314 cases (61.9%), mandibular hypoplasia in 69 cases (13.6%), mandibular hyperplasia with a frontal open bite in 53 cases (10.5%), maxillary hyperplasia with a cleft in 30 cases (5.9%), maxillary hyperplasia in 22 cases (4.3%), severe laterognathia in 10 cases (2.1%),and isolated frontal open bite in 9 cases (1.5%). The surgical procedures were as follows: bilateral sagittal split osteotomy (n=336, 66%), Le Fort I osteotomy (n=29, 5.9%), bimaxillary osteotomy (n=35, 6.3%), and segment osteotomy (n=107, 21.1%). Rigid fixation was used in 147 patients. Results. In 55% of the patients a postoperative neurosensory deficit of the inferior alveolar nerve was observed, which was only found in 28% after 1 year. Inflammatory wound healing was found in 5.3% of the patients. Conclusion. Due to antibiotic perioperative prophylaxis and modern rigid osteosynthesis devices, orthognathic surgery has become a routine method in maxillofacial surgery with predictable surgical results.