Whilst there have been great improvements in the management of injuries in elite and professional athletes with the formalisation of the clinical specialty of sports and exercise medicine, the management of facial injuries has perhaps lagged in this group. Professional athletic careers can be put in jeopardy by unnecessarily long absences from training and competition after facial injuries. Professional and elite sports athletes can benefit from different approaches to the management of their facial injuries that reduce time away from competing but maximise their safety. On 6 December 2018, a consensus meeting of interested clinicians involved in the management of facial injuries in this group was held at the Royal Society of Medicine, London, UK to provide a contemporary review of the approaches to conservative, operative, and recovery management. National experts with specialist experience of facial injuries and athletes' needs from a range of elite and professional sports led the day's programme and the discussions so that guidelines could be formulated. These are presented in this review.