Secondary traumatic reconstruction of the temporomandibular joint (TMJ) remains a challenging prospect for treating clinicians when attempting to restore function and form of this complex joint which, in its native form, functions with both translational and rotational movements. Condylar fractures account for around a quarter of all mandibular fractures highlighting the common nature of this type of injury. Potential late complications of traumatic TMJ injuries include facial asymmetry, malocclusion, growth disturbance, osteoarthritis, and ankylosis with potential functional problems. Treatment modalities range from conservative to total joint replacement surgery, which largely depends on the extent of the problem and the clinical presentation. When the mandibular condyle is extensively damaged, degenerated or lost, replacement with either autogenous graft or alloplastic implant is an acceptable approach to achieve optimal functional and symptomatic improvement. The goals of TMJ reconstruction primarily are to improve mandibular form and function, to relieve pain where possible, provide cost-effective treatment, and to avoid complications and morbidity. Autologous TMJ reconstruction has included the use of the metatarsal graft, costochondral graft, coronoid process, scapula tip, iliac crest, sternoclavicular, deep circumflex iliac artery flap and of increasing recent use, the fibula free flap which is now widely accepted as the “gold-standard” for mandibular reconstruction. With now over 27 years of reported data, alloplastic devices have proven efficacy and safety, with outcomes similar or superior to standard orthopedic knee and hip prosthetic devices. Currently, TMJ Concepts (Ventura, CA) produces a patient-specific custom device utilizing CAD-CAM 3D technology, whereas Zimmer-Biomet Microfixation (Warsaw, IN) produces both stock (in the United States) and custom devices (not available in United States). Reconstruction of the TMJ is not without complications, the most common of all is postoperative infection, with other complications including heterotrophic bone formation and persisting pain.