The majority of frontal sinus fractures are the result of high-velocity injuries, such as motor vehicle accidents, assaults, and sporting events. Patients often have associated injuries. The initial evaluation should focus on airway control and hemodynamic stability. The head and neck examination should focus on injuries to brain, spine, orbits, and facial skeleton. This requires a team approach involving the otolaryngologist, neurosurgeon, and ophthalmologist. The treatment goals for repair of frontal sinus fractures include avoidance of short- and long-term complications, the return of normal sinus function, and reestablishment of an esthetic facial contour. A treatment algorithm and surgical approach to the management of frontal sinus fractures will be presented.