Objectives: The current study is designed to compare between hydraulic pressure technique and osteotome technique for maxillary sinus lifting with dental implant placement via trans-crestal approach. Patients and Methods: Twelve patients with average age (18 to 45) years old with inadequate bone height below the maxillary sinus floor were randomly divided into two groups: group (A): Patients received dental implants after sinus lifting using hydraulic pressure technique. Group (B): Dental implants were placed after trans-crestal sinus lifting using Osteotomes. Follow up: done immediate after implant placement and after six months by cone beam computed tomography (CBCT) to measure bone density and gained bone height. Paired t-test, and descriptive statistics were used to evaluate the gained bone height and bone density. Results: Sinus lifting with hydraulic technique and osteotome technique were effective with superior clinical and radiographic results of hydraulic technique. Twelve implants were placed. Follow up CBCT showed, mean bone height after 6 months in group A was12.07±2.22. while in group B was 8.29±1.96 mm. Conclusions: hydraulic technique and osteotome technique are successful methods for sinus lifting with superior clinical and radiographic results of hydraulic technique.