There are many causes of hypomobility of the Temproromandibular Joint (TMJ). Trismus secondary to pathologic conditions outside of the TMJ are called pseudoankylosis or extra-articular ankylosis. The treatment of TMJ pseudoankylosis can be divided to conservative or surgical. Although, conservative therapy and physical rehabilitation are considered the first line of therapy, surgical intervention should be considered for cases of osteogenic character or severe extra-articular ankylosis resistant to conservative treatment. We present two unusual cases of severe TMJ pseudoankylosis. One, of a 27 years old female who suffered persistent posttraumatic TMJ pseudoankylosis after jaw fracture surgery. She was successfully treated with a release and free radial forearm intraoral reconstruction. The other case is of a 52 years old man with chronic trismus with myositis ossificans traumatica secondary to previous traumatic injection of the superior alveolar nerve during root canal of a left maxillary molar. He was treated by release and coronoidectomy. We describe our surgical treatments and review the treatment algorithm of TMJ ankylosis.