The purpose of our study was to determine the risk factors of incurring maxillofacial fractures among individuals who engage in unarmed hand-to-hand combat. The following retrospective cohort study was completed using data from the Nationwide Inpatient Sample. The primary predictor variable was blood alcohol level. The primary outcome variable was maxillofacial fracture. We used SPSS to conduct all statistical analyses. Our final sample consisted of 9,441 patients injured from unarmed hand-to-hand combat. The mean age of the sample was 38.7 years. The most common age group was young adults (42.9%), followed closely by middle-aged adults (41.9%). The number of males was nearly 4 times that of females. The mandible was the most frequently fractured maxillofacial bone. Concerning the mandible per se, the angle (37.1%) was the most frequently fractured site, while the coronoid process (0.2%) was the least frequently fractured site. Relative to females, males were 2.7 times more likely to incur a craniomaxillofacial fracture (P < .5). Males had an increased risk of maxillofacial fracture relative to females. The mandible, particularly the angle, was the most frequently fractured maxillofacial bone. We speculate this is because hooks are frequently thrown in unarmed hand-to-hand combat.