Temporomandibular joint disorders have a negative effect on a wide portion of the population. An important part of these disorders involve internal derangement problems. Main causes of internal derangements can be classified as acute macrotrauma, chronic microtrauma, or developmental and acquired defects. Treatment of patients with temporomandibular joint internal derangement typically begins with nonsurgical treatment modalities. Bite appliance therapy, diet modifications, nonsteroidal anti-inflammatory medications, muscle relaxants, moist heat or ice, and physical therapy have been found to be effective. Surgical treatment is employed only after failure of initial nonsurgical treatment. The goal of surgical treatment of temporomandibular joint internal derangement is to regain adequate nutrition and masticatory functions. In this seminar; the treatment modalities, long term results and complications of open surgical treatment of temporomandibular joint internal derangements are reviewed.