Objective: The purpose of this systematic review was to assess the difference in the incidence of intraoperative and postoperative complications between the conventional and alternative surgical techniques, during sinus floor augmentation surgery. Data Sources: Electronic databases were searched for publications related to sinus floor augmentation surgery performed with different techniques (ie, conventional lateral window, piezosurgery, osteotome, trephine) and the incidence of complications. The articles were evaluated by independent reviewers, according to predetermined inclusion/exclusion criteria and processed for meta-analysis, following the PRISMA protocol. Initial search returned 3,940 articles, after inclusion/exclusion criteria, and quality assessment 11 articles were included in the meta-analysis: five randomized clinical trials and six retrospective studies. All the 11 included studies compared the incidence of complications in conventional lateral window sinus augmentation surgery versus alternative techniques, including: osteotome (five articles), piezosurgery (four articles), sonic surgery (one article), and trephine (one article). Meta-analysis of the incidence of intraoperative and postoperative complications during conventional lateral window sinus floor augmentation surgery versus alternative techniques, showed a significantly lower incidence of intraoperative complications for the retrospective studies. However, when data from the clinical trials alone were included in the meta-analysis, a statistically significant difference could not be detected for the incidence of intraoperative and postoperative complications. Conclusions: The use of alternative techniques for sinus floor augmentation surgery (ie, piezosurgery, sonic surgery, osteotome, and trephine) does not necessarily reduce the incidence of intraoperative and/or postoperative complications compared to the conventional technique. Schlagwörter: dental implants, intraoperative complications, piezosurgery, postoperative complications, sinus floor augmentation, review