Introduction  This study aims to evaluate the efficacy of open reduction and the combination of open reduction with mandibulomaxillary fixation (MMF) in cases of unfavourable mandible fractures.   Materials and Methods   This is a prospective study carried out from 2010 to 2015 on 60 patients with mandible fracture attending the Dept. of ENT.  The diagnosis and classification of mandible fracture into favourable and unfavourable types were done on the basis of clinical and CT faciomaxillary findings. The outcomes were assessed by comparing the preoperative and postoperative occlusion, mouth opening and symmetry of mandibular ramus. Patients with favourable mandible fractures were excluded from the study.   Results   We found that out of 60 patients, 40 cases were of the unfavourable type. ORIF with MMF gave better outcome compared to ORIF alone. The data were statistically analysed using Z score and P value.   Conclusion  Initial assessment of mandible fractures into favourable and unfavourable category plays a significant role in planning the management.  Management of unfavourable mandible fractures with ORIF and MMF gives functionally and aesthetically better results as compared to ORIF alone.