Various conditions are responsible for the development of acquired temporomandibular joint (TMJ) defects, the reconstruction of which represents a unique challenge, as the TMJ plays an important role in the functioning of the jaw including mastication, deglutition, and phonation. Autogenous reconstructions such as costochondral or sternoclavicular joint graft continue to be the best option in children, owing to their ability to transfer a growth center. In adults, alloplastic reconstructions are a safe and predictable option. Vascularized tissue transfers have also become a popular and reliable way to restore these defects. © 2013 Elsevier Inc.