This handbook is useful in the diagnosis,Management and Treatment of NOE Fracture of facial skeleton.NOE fractures occurs 5% of all adult facial bone fractures. in pediatric population, NOE fracture is more common and the accounts 16% of facial bone fractures. Naso-orbital-ethmoid fractures are caused by a high-impact force applied anteriorly to the nose and transmitted posteriorly through the ethmoid bone. Associated injuries include: telecanthus secondary to medial canthal tendon injury nasolacrimal duct disruption and subsequent frontal mucocele formation orbital injuries and exophthalmos due to reduced intra-orbital volume cerebrospinal fluid rhinorrhea due to fracture through the cribriform plate. Prompt and proper management of these injuries can achieve both adequate functional and aesthetic outcomes.