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Background/Objectives : Mandibular fractures are among the most common facial injuries. Bilateral fractures of the mandibular body region (BBMFs), however, are rare. The aim of this retrospective study was to analyze the characteristics, surgical management, and outcomes of BBMFs in a third-level trauma center in northern Italy. Methods : Between 1 January 2001 and 31 December 2023, the following data were collected about patients hospitalized for BBMFs: age, sex, cause of fracture, dental status, degree of mandibular atrophy, surgical approach, number and thickness of plates used, concomitant maxillofacial fractures, length of hospital stay, and outcomes. Statistical analysis was performed using SPSS software. Results : During the study period, 26 patients (11 males and 15 females) presented with BBMFs, of which five were dentate (median age, 19 years) and 21 edentulous (median age, 80 years). The primary cause of trauma was road traffic accidents (RTAs) in dentate patients and falls in edentulous patients. In most dentate patients, fractures were treated using an intraoral approach with rigid or mixed fixation, using ≤1.4 mm thick plates. Edentulous patients were primarily treated using an extraoral approach and rigid fixation with ≥1.5 mm plates. The use of plates ≥ 1.5 mm was statistically associated with edentulous patients ( p = 0.042) and with increasing degrees of atrophy ( p = 0.020). Conclusions : This study shows that BBMFs are uncommon injuries, associated with high-impact trauma in dentate patients and medium- or low-impact trauma, such as falls, in edentulous patients. Internal fixation was predominantly rigid, with thicker plates used as the degree of mandibular atrophy increased.