Introduction: Piezoelectric surgery is an osteotomy technique that can help to minimize tissue trauma and its complications. It is a safe technique since it only works on the mineralized tissues, leaving the surrounding tissues' perfusion and innervation unaffected. It reduces tissue thermal damage and prevents osteonecrosis. Aim: The aim of study was to evaluate the effect of using Piezosurgery on pain, swelling, and trismus after surgical extraction of impacted mandibular third molar. Patients and methods: This study was conducted on healthy patients classified as ASA class I patients. Fifteen patients with bilateral, symmetrical, mandibular impacted third molars that needed surgical extraction were selected and divided randomly into two equal groups 15 teeth for each group. The same patient is considered as control and study group. Group A: Underwent surgical extraction of impacted mandibular third molar with a conventional rotary device. Group B: Underwent surgical extraction of impacted mandibular third molar with piezoelectric device. Pain, edema, and trismus were evaluated after 2 and 7 days postoperatively, and the total number of analgesic tablets taken by the patient till day 7 was counted. Results: The results showed there was significantly less pain, edema, and trismus with piezosurgery compared to rotary instruments after 2 days and 7 days postoperatively. The total number of analgesics taken by the patients was significantly less with piezosurgery compared to conventional group. Conclusion:The use of piezoelectric surgery for bone removal during the extraction of impacted mandibular third molar reduces postoperative pain, edema, and trismus.