Objective: Conventional orthognathic surgery (OGS) requires orthodontic preparation prior to surgery.Surgery first approach is a technique that is gaining prominence and popularity in recent years.We want to discuss the advantages, limitations and considerations of this method.We will also discuss the results of some cases performed at our centre in Singapore.Methods: 8 consecutive cases were examined and their progress and results were analyzed.Results: The data and results from the OGS cases will be presented and discussed.Conclusions: Surgery first approach for OGS is a good technique that can produce good result with shorter treatment duration for suitable cases.