Internal joint derangement is a disruption of the internal aspects of the TMJ-disc displacements/adhesions/impingements, causing alterations in the normal dynamic motions of the joint. Clinicians must be diligent in establishing the correct diagnosis and cause of TMJID, which ultimately leads to the appropriate management of such patients. While many patients adapt over time or with non-surgical treatment, surgery may be indicated for those with ongoing problems. The surgical pyramid provides a stepwise progression for TMJ surgical patients. This paper aims to review TMJID and its management with special emphasis on arthroscopic minimally invasive surgery, as practised in other countries around the world, and compare this to current education, understanding and practice in India. Currently, India is lagging behind in providing the full scope of TMJ services as there are very few surgeons trained in the skill of arthroscopic techniques. There needs to be continued expansion of our understanding of TMJID treatment in India to bring it level with the rest of the world.