Ankylosis of Temporomandibular Joint (TMJ) is a condition which causes deficient facial aesthetics leading to malnutrition due to trismus. It also causes speech disturbances with long standing psycho-social impact. This case series presents phase wise management of long standing unilateral TMJ ankylosis in 2 patients. In both of our patients, prior tracheostomy followed by Al-Kayat Bramley incision helped in adequate exposure. Use of temporalis muscle & fascia as a inter-positional graft following a gap arthroplasty with graded physiotherapy and dietary management resulted in good outcome as evidenced by the stable mouth opening in the follow- up periods and improvement in self-image of the patient. Patient counselling by regular follow up and speech therapy was also performed. Early diagnosis and surgical management of TMJ ankylosiswith physiotherapy is a key determinant in improving facial aesthetics and masticatory function of TMJ ankylosis patients which may have long term psychologic-social impact on their quality of life.