A systematic review of the literature concerning surgical engineering in cranio-maxillofacial surgery was performed. APubMed search yielded 1721 papers published between 1999 and 2011. Based on the inclusion/exclusion criteria, 1428 articles were excluded after review of titles and abstracts. Atotal of 292 articles were finally selected covering the following topics: finite element analysis (n = 18), computer-assisted surgery (n = 111), rapid prototyping models (n = 41), preoperative training simulators (n = 4), surgical guides (n = 23), image-guided navigation (n = 58), augmented reality (n = 2), video tracking (n = 1), distraction osteogenesis (n = 19), robotics (n = 8), and minimal invasive surgery (n = 7). The results show that surgical engineering plays a pivotal role in the development and improvement of cranio-maxillofacial surgery. Some technologies, such as computer-assisted surgery, image-guided navigation, and three-dimensional rapid prototyping models, have reached maturity and allow for multiple clinical applications, while augmented reality, robotics, and endoscopy still need to be improved.