Medical photography is an essential tool in orthognathic surgery to facilitate diagnosis, preoperative planning, and follow-up. Photographic documentation has clinical, research, teaching and legal applications. An accurate diagnostic approach and surgical planning of dentofacial deformity requires the ability to work with reproducible and measurable photographic images. It must also respect certain legislative rules for its use within a health institution and the dissemination of images in the educational and scientific framework. We propose through this narrative review a standardized protocol to obtain reproducible images in the different planes of space. We also review and discuss fundamental points for setting up a photographic room dedicated to photography in orthognathic surgery.