Cow sports and cow attack are most common reason for maxillofacial injuries in rural areas. These injuries are so severe; it requires hospital admission and surgery. To study the mode of injury caused by cow attaches, type of maxillofacial fracture and type of surgery. Data were collected retrospectively for six years between January 2012 and December 2017 from a rural south Indian medical college and hospital. Data regarding age, sex, occupation, mechanism of injury, situation of injury, facial bone fracture site and surgery done were collected. Association between age, sex, occupation and mechanism of injury, facial bone fracture site were established using chi-square test. A total of 64 attacks were recorded during study period, involving 43 males and 21 females. 15–45 year age group was more commonly affected with male being predominant. Farming and cow sports account 68.8% and 18.8% of occupation injury respectively. Kick and head butt (75.6%) was the commonest mechanism of injury, feeding and milking (82.2%) accounted for situation of injury, mandible (71.1%) was more commonly fractured when compared to other facial bones. Cow sports and farming without protective measures have been major cause for increase in Maxillofacial bone fractures among rural areas. Cow being the big domesticated animal among rural India, injuries caused by them can be devastating and psychologically disturbing, hence adequate knowledge regarding handling of these domestic animals is of utmost important.