Purpose Meeting with local needs of low- and middle-income countries during maxillofacial humanitarian mission is not easy. This article aimed to report on 5 years of experience in humanitarian maxillofacial surgery missions. In addition, several key points for best practices and meeting the medical needs of local populations are discussed. Methods In this retrospective case series, all medical charts of patients managed during humanitarian maxillofacial surgery missions organized within the department of maxillofacial surgery of Le Dantec Hospital (Senegal) were analyzed. Disease characteristics, treatments modality, and outcomes were reviewed. Moreover, missions planning and costs were studied. Results Between 2015 and 2018, 5 humanitarian missions were organized totalizing 177 patients, one-third of which were treated surgically. Tumors (35%) and sequelae from previous surgeries, NOMA or trauma (24%) were the most frequently treated disorders. Most patients were treated with free flap reconstructions (35%). Postoperative complications were observed for only 3 patients (5%). With a median follow-up of 13 months, no sequelae requiring specific treatment were observed. The estimated total cost for each mission was $39,000. Conclusion In order to benefit both the locals and the volunteers, humanitarian maxillofacial missions should be carefully planned and volunteers appropriately prepared. Other keys to the success of such missions are setting up training and support programs, reflecting upon ethical considerations, understanding local cultural customs and ensuring mutual respect with the locals. Frequent self-evaluation and long-term mission sustainability are critical. Finally, mission costs should be evaluated.