Vertical ridge augmentation (VRA) procedures before or during dental implant placement are technically challenging and often encounter procedure-related complications. To minimize complications and promote success, a literature search was conducted to validate procedures used for VRA. A decision tree based on the amount of additional ridge height needed ( 4, 4 to 6, or > 6 mm) was then developed to improve the procedure-selection process. At each junction, the clinician is urged to consider anatomical, clinical, and patientrelated factors influencing treatment outcomes. This decision tree guides selection of the most appropriate treatment modality and sequence for safe, predictable management of the vertically deficient ridge in implant therapy.