Hemifacial microsomia is a congenital deformity that can vary from mild to severe. The structures most commonly affected are the ear, malar bone, and the mandible. The primary deformity often produces compensatory alterations in hard and soft tissue growth, as well as resultant occlusal disharmonies. The objectives for treatment of a patient with mehimfacial microsomia are the establishment of normal dental occlusion and temporomandibular joint function and the achievement of facial symmetry. Treatment frequently requires the services of a multidisciplinary team, most notably the orthodontist and surgeon. Three cases, varying from mild to severe, are presented to demonstrate clinical findings associated with hemifacial microsomia and the combined orthodontic and surgical approach used in their management.