Objective: The aim of this randomized two-center study was to compare quantic molecular resonance scalpel (QMRS) with traditional scalpel (TS) for the surgical treatment of labial mucoceles, in terms of impact on quality of life and postoperative pain (primary outcomes) and postsurgical lip paresthesia and recurrence of the lesion (secondary outcomes). Method and Materials: Eighty-five consecutive patients with labial mucoceles were randomized to receive traditional (46) or QMRS surgery (39) in two Italian University Hospital Centers. Patients were asked to complete three different forms during the first week after surgery to evaluate quality of life and postoperative pain. Periodic follow-up examinations were conducted at 1 week, 1 month, and 3 months after surgery, in order to detect recurrence of lesion and/or lip paresthesia. Results: Regarding the symptoms reported during the first week after surgery, questionnaires given to the patients and the mean painkiller consumption did not demonstrate any statistically significant differences within the two groups. Women treated with QMRS reported a worse experience than women treated with TS (P .05). Among all the mucoceles treated, during the follow-up period of 3 months, one that had been eliminated with the cold scalpel was seen to relapse, versus none of those treated with the QMRS (P = 1.0). We reported a localized and terminal paresthesia of the labial mucosa close to the surgical site in 10.58% of the total patients. Comparing the QMRS with TS, we observed a greater incidence of neurologic complications with the latter technique (P = .035). Conclusion: This is the first prospective randomized study to report outcome data and 3-month follow-up of a cohort of patients suffering from labial mucoceles. QMRS for surgical removal of labial mucoceles seems to be comparable to traditional scalpel in terms of postoperative quality of life, pain, and postsurgical lip paresthesia. Keywords: labial mucoceles, outcome, quantic molecular resonance scalpel, surgery