Abstract Although temporomandibular joint pain is not a rare complication of mandibular surgery, styloid pain syndrome has not been recognized heretofore as a complication of mandibular osteotomy. Usually styloid pain syndrome occurs following tonsillectomy or de novo. Most styloid syndromes involve the styloid process, the stylohyoid attachments, or the carotid artery. This article presents a case of stylohyoid pain syndrome caused by stretching of the stylomandibular ligament following mandibular osteotomy. Additional surgical intervention was required to relieve the symptoms in this case. Styloid process pain syndromes are reviewed.