Osteoradionecrosis of the mandible refers to necrosis of bone and often with surrounding tissues after radiotherapy. This is often compounded by chronic infection, leading to debilitating outcomes on the patient's quality of life. In this article, we discuss the incidence, risk factors, diagnosis, staging, pathophysiology, and management of this condition. We discuss our experience in managing this condition, which can vary depending on severity and patient factors, when taking into account approaches ranging from conservative to surgical resection and free flap reconstruction.