The principles of the management of deep space head and neck infections include early and rapid assessment of the severity of the infection by anatomic location, rate of progression, and the potential for airway compromise. After evaluation of host defenses, early definitive surgical management is a key to arresting further progression of the infection. The use of drains, medical supportive care, and follow up management of these infections are presented. Unusual and complicated infections are illustrated with cases, including necrotizing fasciitis, brain abscess, mediastinitis, and cavernous sinus thrombosis.Orofacial infections usually spread in a predictable fashion from one anatomic space into another, depending on the site of origin and the causative organism. The ability of the oral and maxillofacial surgeon to predict the clinical behavior of deep space infections of the head and neck make this specialist the expert in the management of these conditions. That anatomic and surgical knowledge is summarized in this lecture, including the borders, contents, relations, and likely causes of infections in the deep fascial spaces. The clinical presentation, diagnosis, and surgical therapy of infections of each of these spaces are illustrated with several cases.Anesthetic and airway considerations in the management of orofacial infections are then discussed. The diagnosis of airway compromise is reviewed, and currently available airway management techniques are compared.These considerations are supported by data resulting from a recently published prospective study of 37 severe odontogenic infections recently completed at the Montefiore Medical Center, Bronx, NY. The principles of the management of deep space head and neck infections include early and rapid assessment of the severity of the infection by anatomic location, rate of progression, and the potential for airway compromise. After evaluation of host defenses, early definitive surgical management is a key to arresting further progression of the infection. The use of drains, medical supportive care, and follow up management of these infections are presented. Unusual and complicated infections are illustrated with cases, including necrotizing fasciitis, brain abscess, mediastinitis, and cavernous sinus thrombosis. Orofacial infections usually spread in a predictable fashion from one anatomic space into another, depending on the site of origin and the causative organism. The ability of the oral and maxillofacial surgeon to predict the clinical behavior of deep space infections of the head and neck make this specialist the expert in the management of these conditions. That anatomic and surgical knowledge is summarized in this lecture, including the borders, contents, relations, and likely causes of infections in the deep fascial spaces. The clinical presentation, diagnosis, and surgical therapy of infections of each of these spaces are illustrated with several cases. Anesthetic and airway considerations in the management of orofacial infections are then discussed. The diagnosis of airway compromise is reviewed, and currently available airway management techniques are compared. These considerations are supported by data resulting from a recently published prospective study of 37 severe odontogenic infections recently completed at the Montefiore Medical Center, Bronx, NY.