The Le Fort I osteotomy is a relatively simple procedure, commonly performed by oral and maxillofacial surgeons, with little morbidity. For pathological conditions of the nasopharynx, cranio-cervical junction and base of skull, the procedure provides good visualization to otherwise awkward anatomical areas. Nine such operations have been performed together with ear, nose and throat surgeons and neurosurgeons for various lesions. Particular reference is made to one case which illustrates the reliability and versatility of the approach, especially when combined with a midline palatal split.