The author's personal experience with 84 patients demonstrating varying degrees of facial atrophy is reported. Of these, 59 patients had forms of progressive hemifacial atrophy. Hemifacial atrophy seems best classified into two groups: those who demonstrate inflammatory changes during the course of the disease as opposed to the more benign or noninflammatory types. The inflammatory type of hemifacial atrophy is usually associated with skin and ophthalmic pathology. It is suggested that it is often difficult, if not impossible, to distinguish between Romberg's disease and hemifacial atrophy from scleroderma; therefore, these terms might best be eliminated in classifying hemifacial atrophy. The etiology of facial atrophy remains unknown in the overwhelming majority of cases.