INTRODUCTION: Dental implantology, a special field of dentistry dealing with the rehabilitation of the damaged chewing apparatus due to loss of the natural teeth, is currently the most intensively developing field of dentistry. Missing teeth can be replaced using dental implants, which are inserted into root bearing parts of the mandible or maxilla. The success and long-term prognosis of implant prosthetic therapy depend primarily on the anchorage of the implant in the jaw bone OBJECTIVES: The main objective of this study was to assess clinically and radiographically the flapless versus conventional flap surgical technique in the maxillary esthetic zone. MATERIALS AND METHODS: This study was a randomized controlled clinical trial. It included 16 dental implants. The patients were divided in to two groups: group A, eight implants were placed in the maxillary aesthetic region using flapless procedure, and group B eight implants were placed in the maxillary esthetic region using flap procedure. All patients followed by clinical and radio-graphical evaluation over a period of 6 months. RESULTS: The flap technique showed statistically significant higher mean pain severity and duration, plaque index, probing depth, healing score than the flapless technique. The radiographic evaluation of the flapless implant surgery showed marked decrease in the amount of crestal bone loss in comparison to conventional flap. The mean horizontal and vertical bone loss around implants was significantly less in group A than in group B. There was no difference in bone density between both groups. CONCLUSIONS: The flapless implant surgery reduces the amount of crestal bone loss, soft tissue inflammation, pain, edema, bleeding and consequently soft tissue recession than the conventional flap technique