This study was conducted to evaluate the efficiency of sandwich osteotomy with hybrid inlay graft (autogenous bone Mini-Blocks + Platelet Rich Fibrin) in the vertical augmentation of the atrophied posterior mandibular ridges without the use of fixation devices (mini plates of screws). This study was conducted on seven patients, in which eight segments were elevated using sandwich osteotomy with hybrid inlay graft. The segments were evaluated radiographically using cone beam computed tomography. From the results the average amount of vertical augmentation gained was 3.68 mms which is equivalent to 44.9% of the preoperative vertical ridges height and the average amount of bone loss after 4 months healing period was 1.39 mms or what’s equivalent to 37.89% of the amount of augmentation gained immediately post operative. Thus, concluding that the sandwich osteotomy with hybrid inlay grafting is a reliable technique for vertical ridge augmentation of the atrophied posterior mandible with high success rates, decreased complications and low predictable rate of bone resorption.