PURPOSE To determine if immediate admission and shorter time to surgery decreases the rate of post -operative infections in patients with mandible fractures treated at a major urban trauma center. METHOD A retrospective chart review was performed for a one -year period (6/2007-6/2008) for all patients undergoing operative treatment of mandible fractures at an urban trauma center. Maxillofacial trauma call is shared between three services: plastic surgery, otolaryngology, and oral surgery. Patients are therefore randomized by date of presentation to one of three treatment teams, which may have differing practice patterns. Date of injury, date of admission, date of surgery, and incidence of infection were recorded with a minimum 5- month follow-up period. Patient demographics were comparable between groups. RESULTS The total number of new mandible fractures undergoing surgical treatment in a one- year period was 60 (n=60). Average time from injury to surgical repair was 5 days (range 0-10 days). 25% of patients were admitted upon presentation to the emergency room, with an average time to surgical repair of 2.25 days (range 0-5 days). Overall, 35% of patients had surgery within 72 hours of injury and the infection rate was 5% in this cohort of patients. While admission did result in shorter time to treatment, there was no clear association between immediate admission to the hospital, treatment with IV antibiotics, shorter time to treatment, and rate of postoperative infection. CONCLUSION While the literature advocates early repair of mandible fractures, analysis of our practice patterns suggest immediate admission and shorter time to treatment does not decrease infection rates, even in a high-risk population. Our infection rate is comparable to those commonly cited in the literature. Selection bias may be a factor, in that the patients with worse fractures are admitted and undergo surgery sooner than those patients with more simple fractures. Had those patients not been admitted, it is possible that a higher rate of infection might have been observed. Our sample size is also relatively small, especially when divided between three different practitioner groups. The data does not show significant difference in treatment patterns between groups.