The purpose of this study was to compare the safety and effect of piezosurgery with conventional osteotomy in a boxshifting procedure for orbital hypertelorism (ORH) correction surgery. This study retrospectively analyzed the clinical record of 10 ORH patients aged from 5 to 12 years, and they were seconddegree ORH with an interorbital distance (IOD) of 35 to 37.8 mm. Three of them received the osteotomy with piezosurgery (the piezosurgery group), whereas the other 7 patients received osteotomy with the conventional osteotomy method (the control group). They were compared with age and preoperative IOD. All the patients' IOD was effectively improved to normal range after the surgery. The results showed that the application of piezosurgery did not prolong the surgery time (piezosurgery group: 8.3 ± 0.5 hours; control group: 8.7 ± 1.4 hours, P = 0.68). Furthermore, the patients in the piezosurgery group had less drainage volume (piezosurgery group: 79.1 ± 12 mL; the control group: 170 ± 41.3 mL, P = 0.0065) and shorter postoperative hospital stay (piezosurgery group: 8.3 ± 2.0 d; control group: 12.43 ± 2.29 d, P = 0.029). There were 2 patients who had wound infections, 1 in the piezosurgery group and 1 in the control group, respectively. However, 1 patient in the control group suffered from cerebrospinal fluid leakage. On the basis of the results, the application of piezosurgery benefited the patients on a better and smoother recovery course with less drainage and shorter hospital stays. The advantages of piezosurgery are the fine and precise osteotomy and the protection for soft tissue, which make it a comparatively safe and effective tool for craniofacial surgery, especially for young patients.