Ankylosis of the temporomandibular joint and the possibly associated deformation of maxillofacial bones are functionally and aesthetically serious problems. Despite the developments in oral and maxillofacial surgery, treatment of patients with ankylosis of the temporomandibular joint still remains challenging. This article presents a review of the developments in this treatment, 25 years after the publication of the thesis Temporomandibular joint ankylosis. Nowadays, computertomography is the standard for imaging assessment, possibly combined with stereolithography. Resection of the ankylotic mass is the surgery method of choice. The gap is filled by interpositional tissue transfer of temporalis muscle or a fascia flap. Early mobilisation and intensive physiotherapy are needed. In case of maxillofacial asymmetry, distraction osteogenesis has proved to be successful.