Background and Objectives: The incidence of recorded maxillofacial trauma continues to increase worldwide and as expected the etiology and types of injuries vary among different countries. Previous studies support that the differences in both patterns and etiology of maxillofacial fractures depend to a large extent on cultural, social and economic variables. As an example, in developed countries, especially in Europe, physical assaults were the main cause of maxillofacial fractures, followed by motor vehicle accident (MVA). The aim of this retrospective chart study was to analyze the demographics, causes, incidence and patterns of maxillofacial fractures in patients from the western region of Saudi Arabia treated at King Fahd Hospital, Saudi Arabia (KFGH). Methods: Patients treated between 1998 and 2018 at the department of maxillofacial surgery in KFGH were reviewed. Patient’s age, sex, pattern of facial fracture, and causes of injury were recorded. Data was analyzed using SPSS Pc+ 21.0 version statistical software. Results: A total of 616 patients (87% n = 536 male and 13% n = 80 female) with 886 fractures were recorded. The age group ranging between 20 to 29 years (39.2%; n = 238) sustained the highest incidence of maxillofacial fractures. Of the different causes of trauma, i.e., MVA, falling from heights, fighting, sports injuries and others MVA was listed as the main cause in 369 (59.9%) patients [male (n = 316) / female (n = 53)]. Of the different potential anatomical sites (Maxillary, Orbital, Nasal, ZMC, Frontal, Mandibular, Dentoalveolar, Lefort I, Lefort II and Lefort III), the mandible was found to have the highest rate 61.2% (377 out of 616), followed by ZMC (37.2%), Orbital (12.8%), Nasal (7.5%), and Frontal (6.3%). In all types of maxillofacial injuries MVA is the most frequently causative factor (n = 369) compared to Non-MVA factors (n = 247). The association between the cause of accidents and type of injury is statistically significant (p<0.01). Conclusions: In this study, MVA was found to be the most common cause of maxillofacial injuries with the mandible being the most frequent anatomical site affected. Appropriate health education programs and design engineering can be initiated to avoid road traffic accidents and reduce related injuries.