Aim: This study analyzed the factors associated with osteosynthesis removal in patients who underwent a mandibular sagittal split ramus osteotomy. A retrospective analysis of 116 patients undergoing SSRO between 2022 and 2024 was conducted. Methods: Variables such as age, sex, skeletal class, type of movement, and time to removal of the osteosynthesis plates were evaluated. Spearman and Mann-Whitney tests were performed, considering a value P<0.05 as a significant difference to determine associations between these variables and the need for osteosynthesis removal. Two hundred thirty-two SSRO were analyzed, and 292 osteosynthesis plates were installed. Results: Twenty-five patients (21.55%) required plate removal, with a higher prevalence in women (P<0.02). The main cause of removal was plate exposure with or without wound infection (80.39%). Subjects with skeletal class II had a higher incidence of complications (P<0.03), especially those with larger mandibular movements. Plate removal occurred at an average of 7.5±6.1 months postoperatively. Conclusions: Osteosynthesis removal after SSRO should be performed selectively and is primarily related to subjects with a class II facial deformity.