A retrospective study was performed to determine the reliability of primary radiography in evaluation of fractures in the mandible. In all, radiographic diagnosis was correct in 77% of 272 fractures. Panoramic tomography (PT) was superior compared with conventional methods (skull films and jaw projections) in the assessment of these fractures. Without PT, the diagnostic error rate increased to 40%, largely due to missed fracture lines. It is recommended that PT be performed in all cases of suspected jaw fractures, initially, when obtainable, or at least once during the treatment of a jaw trauma patient. Fractures in the dento-alveolar and condylar regions, particularly, presented repeated difficulties in initial radiography.