Aim: The aim of the present study to determine the efficacy of Piezo surgery In Comparison With Conventional Rotatory Technique. Methods: A prospective observational study was conducted in the Department of Dentistry, Jawaharlal Nehru Medical College and Hospital, Bhagalpur, Bihar, India, for 10 months. Group I (N=70) consisted of patients who gave consent forpiezoelectric technique and group II (N=70) consisted of the same patients undergoing conventional rotator osteotomy technique. The intra-operative time was measured in minutes. Post-operative pain, edema and trismus were evaluated on day 1, 3 and 7. Results: The intra-operative time was 26.18±4.976 minutes in Piezoelectric Osteotomy and 8.14 ± 2.37 minutes in Conventional Rotatory Osteotomy. There was a statistically significant difference in the intra-operative time between Piezoelectric & Conventional Rotatory Osteotomy techniques. (p=0.001).Mean post-operative pain on day 1 was 3.44 ± 1.32 in Piezoelectric Osteotomy and 6.88 ± 0.89 in conventional Rotatory Osteotomy. After 7 days, it was 0.11±0.27 in Piezoelectric and 1.48±0.68 in conventional Rotatory Osteotomy. Mouth opening on post-operative day 1 was 27.02±3.55 mm in Piezoelectric Osteotomy and 23.21±2.48 mm inRotatory Osteotomy on day 1. After 7 days, mouth opening was almost same in both the groups and it was 31.11±3.6 mm in Piezoelectric and 31.17±3.22 mm in Rotatory Osteotomy. There was statistically significant change in Postoperative Trismus/Mouth Opening (mm) from day 1 to day 7 among the Piezoelectric & Conventional Rotatory Osteotomy techniques. (p=0.001).Mean post-operative edema significantly reduced from day1 to day 3 and from day 3 to day 7. Mean swelling sizewas 2.33±1.27 mm among Piezoelectric and 5.12±1.07 mm among Rotatory Osteotomy on day 1. After 7 days itwas 0.05±0.212 and 0.79±0.68 in Piezoelectric and Conventional Rotatory Osteotomy techniques respectively. Conclusion: Piezosurgery technique improves quality of patient’s life in form of decrease of postoperative pain, trismus, and swelling. Furthermore, it enhances bone quality within the extraction socket and bone quantity along the distal aspect of the mandibular second mol