The posterior maxilla presents several challenges to the implantologist. An excellent treatment modality that had been into the modern era of dentistry is implant dentistry. The application of implant dentistry could jeopardize the patients presented with deficient alveolar ridges. The most often encountered magnified problem in the posterior maxilla is ridge resorption and sinus pneumatization. This anatomic deficiency can be restored by a procedure called maxillary sinus floor lift. The purpose of this case report is to bring forward such a technique which prevents perforation of sinus lining during implant placement by doing the sinus lift with a direct and indirect approach and to compare both the sinus lift approaches.