A key technique in orthognathic surgery for treating mandibular abnormalities is bilateral sagittal split osteotomy (BSSO). Several modifications have been made to the standard approach over time in an effort to improve surgical outcomes and reduce complications. With an emphasis on how these changes affect clinical outcomes and procedural efficiency, this paper offers a thorough analysis of these changes. Significant changes have been made to BSSO through technological advancements like virtual surgical planning and 3D printing, as well as enhanced instrumentation and surgical techniques. These advancements have resulted in reduced operating times, less postoperative morbidity, and more accurate osteotomies. Case studies highlight improved patient recovery and satisfaction and demonstrate the useful advantages of these changes. Furthermore, the higher efficacy and safety profiles of the modified BSSO procedures are highlighted by a comparative analysis with the traditional methods. The analysis also looks at potential future prospects for BSSO, highlighting the use of cutting-edge surgical techniques and new technologies. This amalgamation of past breakthroughs and present-day progress highlights the dynamic character of BSSO, mirroring continuous endeavours to maximize surgical results and enhance patient care.