The term minimally invasive surgery has described the use of a surgical opening that is smaller than that routinely used to perform similar surgical procedures. A periodontal minimally invasive surgery technique for the placement of bone grafts in periodontal defects is described. The data from 10 consecutive patients on a routine supportive periodontal therapy schedule are presented. The mean healing time of the bone graft sites was 2 5.1 months, the mean probing depth reduction was 4.1 mm, and the mean attachment gain was 4.2 mm. Bone grafting using minimally invasive surgery appears to give results that are similar to results reported using other techniques. Minimally invasive surgery may have the advantage of better retention of graft material and maintenance of tissue height. Patient acceptance of surgical treatment recommendations may be higher because of the perception that minimally invasive surgery represents less surgery.