INTRODUCTION: Rehabilitation of the edentulous posterior maxilla with dental implants is challenging. The deficient alveolar ridge interferes with implant insertion of adequate length placed in the correct position and with the accurate inclination. The transcrestal sinus elevation procedure has become an important preprosthetic surgical procedure for bone creation in the posterior maxilla prior to implant placement. OBJECTIVES: Clinical and radiographic evaluation of using ballooning technique for sinus lift simultaneous with implant placement. MATERIALS AND METHODS: A randomized clinical trial was conducted on fourteen patients who were divided into two groups. Patients, with limited bone height below the floor of the maxillary sinus, were selected on the basis of history, clinical and radiographic examination using cone beam computed tomography. In group A, elevation of sinus membrane using ballooning technique without graft material and implants were placed simultaneously. While in group B, after sinus membrane elevation using ballooning technique, augmentation using biphasic calcium phosphate simultaneously with the implant placement were done. The bone density was measured in Hounsfield unit using ondemand3d software of the cone beam computed tomography. Also, the bone height was measured using cone beam computed tomography. RESULTS: Successful sinus membrane balloon lifting procedures were performed in 14 cases; in both groups there was no sinus membrane perforation. A total of 14 implants were placed. The radiographic examination showed the mean elevated height after 6 months by balloon in group A was 10.43 with SD ±1. 56mm.while in group B was10.31 ± 1.86. CONCLUSIONS: The use of balloon technique to elevate the sinus membrane is a minimally invasive technique and is associated with very little discomfort and complication.