Third molar surgery is a common and complex procedure requiring skills in patient management, anesthesia, and patient and third molar risk assessment with the aim of minimizing local and systemic complications, appropriate surgical training, and holistic care. This chapter aims to highlight principles and recent developments in the optimal care of the patient undergoing TMS, including indications for removal of third molars, patient risk assessment, third molar risk assessment, holistic care for the patient undergoing TMS, surgical approaches, anesthesia, postoperative care, and follow-up. We also highlight some novel developments that may change our practice in the future.