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The mylohyoid nerve is a branch of inferior alveolar nerve, arising from the dorsal division of mandibular nerve. It is given off just before the inferior alveolar nerve passes through mandibular foramen. At times, it provides sensory innervation to the lower teeth and skin below the chin. It is motor to mylohyoid and anterior belly of digastric. At times, the location, anatomic variation and communication of mylohyoid nerve are varied. So, knowledge in depth is needed while treating patients of oral and maxillofacial procedures. Due to the abnormalities, the risk of nerve damage is more and failure in anesthesia occurs. The communication between mylohyoid and lingual nerve was found , as the lingual nerve passes to third molar tooth. The mylohyoid nerve is injured or damaged during procedures like genioplasty by transaction of soft tissue pedicle attached to mental spine and inferior border of symphysis, but it is a rare occurrence. The length of mylohyoid nerve is measured in three sections on the mandible. The posterior section measures about 8.7+/- 0.5 mm , middle section measures 14.5+/- 0.9 mm and anterior section measures about 15.6+/- 1.2 mm in length. This article discusses about the importance and preservation of mylohyoid nerve in oral surgical procedures.