Anterior disc displacement with or without reduction is a common finding in symptomatic and asymptomatic individuals. When symptomatic and associated with dysfunction it requires an intervention. Once nonsurgical management fails and the patient does not respond to minimally invasive procedures, open surgical treatment is indicated. However, controversy exists about whether disc-preservation procedures, such as repositioning/repairing or disc removal, is the preferred treatment. This article evaluates the current evidence supporting both treatment options and highlights the indications, contraindications, and consequences of each.