The frontal sinus and the adjacent naso-orbitoethmoid complex of bones in the midline are vulnerable to direct trauma and significant injuries can involve the adjacent skull base, the nasofrontal duct, and the medial orbit. The anatomy of this critical area is complex. Assessment of the injury includes ocular and neurological examination for associated injuries, and high-resolution computed tomography scanning is required for accurate definition of the injury. In this chapter, the principles of management and the complications of these fractures and their management are described.