Trauma from road traffic accidents and interpersonal violence provide for at least 50% of any maxillofacial Surgeons in Kenya. High speed motor vehicle accidents are common due to the recently developed ‘super highways’ and gunshot injuries are also common due to conflict in neighbouring nations. The management of these injuries in a developing nation is presented with an emphasis on the application of new techniques and older techniques in a challenging environment to achieve desirable outcomes. The use of and adaptation of modern technology in this developing environment is presented.