Pneumatization of the maxillary sinus secondary to posterior maxillary tooth loss is an extremely common finding. Significant atrophy of the maxilla prevents implant placement in this region. For several decades, sinus augmentation has been used to develop these sites for dental implant placement. The main techniques for increasing the vertical bone height of the posterior maxilla are the transalveolar and lateral antrostomy approaches. The clinical and radiographic examinations dictate the appropriate method for each clinical situation. Both techniques have been shown to have high success rates. However, practitioners must be aware of potential complications and how to address them.