The midface is a complex anatomical region which houses functional units and aesthetic structures necessary for normal functioning and psychosocial integration. Most midface defects which require reconstruction can be classified as traumatic, congenital, and postablative. Regardless of aetiology, the goals of reconstruction are always the same – the achievement of functional and aesthetic integrity. The variety of pathology, extent and shape of defects make midface reconstructive surgery a demanding but also exciting and innovative field of surgery that requires an interdisciplinary approach by a number of specialists. Reconstruction methods are numerous today, and the basis of the approach to reconstruction is an understanding of the anatomy and function of the midface, a detailed analysis of defects and knowledge of the principles of plastic-reconstructive surgery. Skin grafts, local and regional flaps are used in the reconstruction of soft tissue defects while bone grafts, alloplastic and osteosynthesis materials are used for bone defects. Today, free flap reconstruction is considered the gold standard of complex defect reconstruction while developments in implantology have enabled stable and sophisticated dental rehabilitation. In addition to surgical methods of complex defect reconstruction, the development of new materials and technologies has significantly improved prosthetic rehabilitation making it a valuable method. Composite tissue allotransplantation and regenerative medicine techniques are also under development. The method of reconstruction should be selected individually, considering the diagnosis, age, and prognosis of the patient, the size, extent, and composition of the defect and the availability of local and distant tissues.