PURPOSE Treating comminuted mandibular fractures remains a challenge. In this study, we used titanium mesh to treat comminuted mandibular fractures. MATERIALS AND METHODS Nine patients with traumatically comminuted mandibular fractures who received open reduction and internal stable fixation with titanium mesh were retrospectively reviewed. Open reduction-internal stable fixation was performed 7 to 10 days after primary debridement of the facial trauma. After the fractured mandible and the displaced fragments were reduced, the titanium mesh was reshaped according to the morphology of the mandible, and the reduced bone fragments were fixed with the reshaped titanium mesh and screws. Then, the surgical effects were evaluated during routine follow-up. RESULTS Most of the displaced fragments were preserved and exhibited a favorable shaping ability in restoring the morphology of the mandible during surgery. No intraoperative complications were encountered. In addition, all patients were infection free, with no obvious resorption in the fixed fragments after surgery. The mandible also exhibited favorable morphology and offered sufficient bone mass for dental implantation or a denture prosthesis. CONCLUSIONS We conclude that titanium mesh shaping and fixation can effectively treat comminuted mandibular fractures with little bone fragment loss, little soft tissue exposure, a low infection rate, and favorable mandibular morphology.