The study aimed to analyze surgical outcomes of the application of computer-assisted real-time surgical navigation on zygomatic fracture surgery. Fifty patients were included in this retrospective review. All patients presented unilateral zygomatic fracture, which the experimental group was reduced and repaired under the guidance of a computer-assisted navigation system and the control group was reconstructed with the traditional freehand method. The mean follow-up time was 356 days. Two-dimensional outcomes were evaluated by the severity of displacement at each key suture line, including zygomaticofrontal, inferior orbital rim, zygomaticosphenoidal, zygomaticomaxillary, and zygomaticotemporal. Three-dimensional outcomes were evaluated by differences between pre-and postoperative parameters, including the distance between the zygomatic surface to porion plane and the midpoint of the zygomatic arch to the mid-porion plane. Displacement <2 mm indicated fair results because it was clinically unrecognizable. There were 40 zygomatic fracture cases from traffic accidents, 4 from falls, and 6 from human altercations. In the experimental group, for two-dimensional evaluation, mean pre-and postoperative displacement showed 4.78 vs. 1.22 mm in zygomaticomaxillary fractures; 1.78 vs. 0.40 mm in zygomaticofrontal; 3.50 vs. 0.07 mm in the inferior orbital rim; 3.06 vs. 0.55 mm in zygomaticosphenoidal; and 2.55 vs. 0.50 mm in zygomaticotemporal (p<0.001). For three-dimensional evaluations, the average differences between the left and right zygomatic surface to porion plane were 4.09±2.12 mm preoperatively and 0.46±0.35 mm postoperatively. The average of differences between the left and right zygomatic arch midpoints to mid-porion planes was 4.89±2.59 mm preoperatively and 0.71±0.44 mm postoperatively (p<0.001). In the control group, for two-dimensional evaluation, mean pre-and postoperative displacement showed 8.09 vs. 1.90 mm in zygomaticomaxillary fractures; 3.25 vs. 0.63 mm in zygomaticofrontal; 5.32 vs. 0.51 mm in the inferior orbital rim; 4.49 vs. 0.76 mm in zygomaticosphenoidal; and 4.40 vs. 0.71 mm in zygomaticotemporal (p<0.001). For three-dimensional evaluations, the average differences between the left and right zygomatic surface to porion plane were 5.58±7.52 mm preoperatively and 1.89±1.06 mm postoperatively. The average of differences between the left and right zygomatic arch midpoints to mid-porion planes was 5.54±3.98 mm preoperatively and 2.60±2.44 mm postoperatively (p<0.001). The surgical outcome between the experimental group and the control group reached statistical significance. The real-time surgical navigation system is an effective technique for guiding zygomatic fracture reduction, with fair surgical outcomes and minimal complications.