In this study, temporal hollowing was classified into primary and secondary traumatic temporal hollowing according to etiology. This was done to analyze the relationship between the nature of different fractures and temporal hollowing. The options for prophylaxis and treatment for temporal hollowing were explored. Data from 428 patients with zygomatic bone and arch fractures between 2004 and 2009 were analyzed retrospectively. The results showed that the incidences of primary and secondary traumatic temporal hollowing were 6.1% and 52.4%, respectively. Moreover, as the severity of fractures increased, the incidence of primary and secondary temporal hollowing increased. A follow-up study of titanium mesh implantation showed that titanium mesh reconstruction resulted in good cosmetic repair without serious complications. Thus, the internal fixation of primary fractures as well as titanium mesh implantation is recommended for patients with serious fractures to reduce the incidence of postoperative temporal hollowing and avoid secondary operations.