Summary This article presents the options and methodologies available for an oral and maxillofacial surgeon to enter private practice: self start-up, purchase of a practice, and associateship. It is entirely possible that, over a practice career, an oral and maxillofacial surgeon could become involved in all three alternatives. Each oral and maxillofacial surgeon and each oral and maxillofacial surgical practice and practice situation are unique. The material is presented as general guides and guidelines to assist an oral and maxillofacial surgeon in getting starting, entering a successful and ethical practice, and covering the major areas and points. Regardless of the type and to enter practice, an oral and maxillofacial surgeon has to make only two decisions: a professional decision and a personal decision. However, they are major and significant career-shaping and lifemolding decisions. They require a tremendous amount of thought, consideration, effort, and expense. They also demand a great deal of patience, perseverance, and time, particularly if the oral and maxillofacial surgeon is a novice and not in the immediate area. On the average, you should allow 6 to 12 months to enter private practice. You must put together your professional advisory team. Speak with other professionals in the community and interview as many as necessary (see Display Box 4). Be as specific as possible as to what you believe you have to do, what you expect them to do with you, and what charges you can anticipate. Many of these talented individuals are empathetic to your novice position and overwhelming responsibilities and are considerate with fees and charges in addition to being extremely helpful. Build relationships. There are many ways to keep certain costs down,5 Purchase astutely. Do not be sold. A wise oral and maxillofacial surgeon once said that “almost everything is negotiable.” In virtually all arrangements you should get several, or at least more than one, bid, quote, or price. This includes loans, leases, insurance, equipment, computers, supplies, professional services, wages, and construction. You must shop the market. At all times, you must be totally professional and highly ethical, even if it hurts or seems impractical. You have been impeccably trained and are superbly talented. You will spend approximately one third of your life in your practice. You have a vision of how you want to spend it. If you keep your eye on the vision, yours will be a highly ethical, extremely productive, totally rewarding, rapidly passing career in a glorious, exciting, challenging field.