Introduction: The purpose of this study was to compare postoperative pain and the amount of analgesic intake after intraoral (IO) cryotherapy versus intracanal (IC) cryotherapy in lower molar teeth with symptomatic irreversible pulpitis (SIP) and symptomatic apical periodontitis (SAP). Methods: Seventy-eight patients were randomly divided into two groups, intracanal cryotherapy group and intraoral cryotherapy group. The patients' postoperative pain was recorded at 6, 12, 24, 48 and 72 hours postoperatively and number of analgesic tablets taken up to 72 hours postoperatively. Results: For pain incidence and pain intensity, there were no statistically significant differences among the groups (P > .05). Intragroup comparisons showed a statistically significant pain reduction when comparing baseline to all other time intervals. As for analgesic intake, intergroup comparison showed no statistically significant difference. Conclusions: Within the study limitations, intraoral cryotherapy proved to be as successful as intracanal cryotherapy in postoperative pain reduction. Both techniques can be used alternatively to keep postoperative pain minimal.