It is often difficult to treat tumors of the pterygomaxillary region because of limited surgical access and nearby critical vascular and neurologic structures. An inferolateral approach, individualized to meet the specific needs of each case, is often ideal for providing adequate access. In previously untreated cases and with smaller lesions, mandibulotomy often is not necessary. Mandibulotomy, when necessary, provides the best visualization of this area and can be accomplished with minimal morbidity. Three illustrative examples are discussed.