Objectives: Trans-alveolar extractions involve surgical removal of tooth that has its own postoperative sequelae, most commonly manifested as pain and swelling. This study aims to compare the efficacy of topical ozone and dexamethasone in management of post-operative sequelae after mandibular trans-alveolar molar extractions. Materials and Methods: Sixty patients requiring surgical removal of mandibular molars under local anesthesia were randomly allocated into two groups, each group consisting of 30 patients. Group 1 received Topical Ozonated Oil in the extraction socket post-operatively, while Group 2 was administered 8 mg dexamethasone injection post-operatively. The patients were checked for postoperative wound healing, pain and swelling on 1st, 3rd and 7th day. Results: The results showed comparatively similar results for the pain severity and swelling score at the 1st and 7th postoperative day in both the groups. A greater reduction of pain was noticed in Group 1 on 3rd postoperative day. Wound Healing was noted to be better in Group 1 at 3rd and 7th post-operative day. Conclusion: In conclusion, topical ozone therapy can be used as an effective alternative treatment modality, when compared to dexamethasone for better management of post-operative sequelae following mandibular trans-alveolar molar extractions.