Introduction Mandible fractures are common in young adults and have a functional impact. This study evaluates a cohort of patients with mandibular fractures in Western Australia to ascertain factors determining operative management. Methods A cohort of 104 patients with 139 mandible fractures were referred to Sir Charles Gairdner Hospital, Plastics and Reconstructive Services from July 2022 to November 2025. Patient factors and referral source were obtained; alongside fracture characteristics such as displacement, malocclusion, fracture favourability and dental instability. Univariable associations were assessed and multivariable logistic regression was used to identify independent predictors of operative management. Results 68.3% of patients were aged between 18 and 39 years with 75% being male. The most common mechanism of injury was assault (42.3%). In the cohort, 78 fractures (56.1%) were managed operatively. Fracture displacement (adjusted OR 5.79, 95% CI 1.48–22.62), malocclusion (adjusted OR 11.97, CI 1.20–119.37), multiple fractures (adjusted OR 8.46, 95% CI 2.70-26.51) and unfavourable fracture pattern (adjusted OR 6.07, 95% CI 1.25-29.56) remained independent predictors of operative management. Angle fractures were more likely to be managed operatively (OR 5.54, 95% CI 1.98–15.50) as well as parasymphysis fractures (OR 2.69, 95% CI 1.01–7.16). Whereas condylar fractures (OR 0.09, 95% CI 0.03–0.24) and ramus fractures (OR 0.20, 95% CI 0.06–0.64) were less likely to be managed operatively. Patient factors such as gender and referral source were not independently associated with operative management. Conclusion Operative management of mandibular fractures was driven primarily by fracture instability and unfavourable biomechanics rather than patient factors. Future prospective studies incorporating patient-reported outcomes may further refine thresholds for operative intervention in mandible trauma.