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Osteoradionecrosis is a serious debilitating and deforming complication of radiation therapy which can adversely affect quality of life and treatment outcome of patients who have already suffered the trauma of oral cancer. It is the long term and most serious side effect of radiotherapy. Features include chronic exposed bone which fails to heal, pain, fractures and fistulae. Though its incidence has decreased as a result of improved radiotherapy techniques, its treatment remains more challenging than ever. Because osteoradionecrosis may be considered a non-healing wound resulting from metabolic and tissue homeostatic disturbances, it responds to different forms of treatment. This review aims to explain this devastating complexity along with its classification and pathophysiology. A thorough knowledge of this subject can help us identify the condition at an earlier stage, when its management is more successful. The various treatment options have also been detailed, along with a mention of the newer therapies.