Development of high-density oil and gas fields presents a great challenge to the energy industry due to the low productivity of individual wells and their high drilling cost. We thus compared the productivity, associated costs and economical revenues gained from two field development scenarios, with multilateral and horizontal drilling, to evaluate the optimal drilling and completion conditions in a giant heavy oil reservoir in the Middle East. Well path design was identified as one of the most complex parameters depending on the well-testing results, field production and reservoir simulation data. The fishbone well of four branches with a length of 300 m each and 30° deviation from the main hole was identified to be drilled and completed using open-hole sidetrack as the best approach. The fishbone structure raised production by 393%, while drilling cost only increased by 130% compared with a conventional horizontal well.