Background: Surgical removal of impacted lower third molars is one of the most common procedure in oral surgery, and usually pain, trismus and facial swelling are the most common complication in the postoperative period. This procedure needs surgical intervention varying from incision of soft tissue, bone removal, and/or tooth sectioning ending by debridement of the flap and suturing. The aim of present study was to evaluate the effect of proteolytic enzyme Serrapeptase on post-surgical edema and trismus after surgical removal of impacted lower wisdom teeth. Methods: This study was conducted on 50 patients ( 27 females and 23 males) classified as ASA I , with impacted lower wisdom teeth ( class II position B ). The age of patients ranged from 20 – 36 years old. Fifty patients were divided into two groups. Group I (study group): Fourty patients had been subjected to surgical removal of impacted lower wisdom tooth under preoperative use of serrapeptase enzyme continued on the use of enzyme every 8 hours for the next five days. Group II ( control group ):Ten patients had been treated without Serrapeptase. Patients in the two groups were followed up clinically and photographically. This facilitated observing the facial appearance and taking accurately the measurements ( pre-operative, 1st, 2nd, 3rd and 5th day measurements of maximum inter-incisal opening , trismus and facial edema ). Results: Numerical data were presented as mean and standard deviation (SD) values. Data were normally distributed (parametric), so Student’s t-test was used to compare between the two groups. Paired t-test was used to study the changes by time within each group. Conclusion: There was a significant difference in facial edema and trismus between both groups on 1st, 2nd, 3rd and 5th postoperative day, so the use of serrapeptase enzyme in this study showed a remarkable decrease in facial edema and trismus. Therefore the enzyme can be used for management of post-operative sequelae after impacted third molar surgical removal. Photographic software can be an added tool to measure the postoperative edema after surgical odentectomy of lower impacted wisdom teeth