Introduction: A zygomatico maxillary complex fracture is a facial bone fracture that commonly occurs as a centrally and laterally protruding zygomatic area. The effective surgical approach and exact reduction of the displaced fracture is the most important task in the treatment of a zygomatic fracture, from the aesthetic point of view. Determination of surgical approach and the fixation point of zygomatic arch fracture is one of the most challenging procedure. The purpose of this case report is to find out that the preauricular incison approach is one of the effective methods for reduction of zygomaticomaxillary complex fracture. Case Report: A 53 years old male patient presented with right zygomatico maxillary complex fractures. Diagnosis of right side tetrapod zygomatico maxillary complex fracture deformity was done by clinical examination and confirmed by computed tomography which included 3-D reconstruction view. The authors performed 4-point fixation using the preauricular approach to counter the disadvantages of the coronal approach. The results and usefulness of preauricular approach with 4-point fixation are reported in this study. Conclusion: Preauricular incision is an effective surgical approach for the reduction of zygomatic arch fracture. 4-point fixation using the easier-to-manipulate preauricular approach would be more useful than the conventional method that uses the coronal approach. Satisfactory reduction that showed exact correction was observed. In an outpatient follow-up, no complication such as nonunion or malunion was found, and facial symmetry was also shown. In addition, the preauricular scar was hardly observed. Keywords: zygomaticomaxillary complex fracture, preauricular incision, reduction, fixation