Purpose: This study compared swelling, pain, and trismus after using the conventional buccal approach and the lingual split technique for the removal of impacted third molars. Materials and Methods: Twenty patients with a mean age of 21.5 years were included. Postoperative edema was followed stereophotogrammetrically for 48 hours by transferring photogrammetric data from three-dimensional profile views into orthographic maps. A visual analog scale was used for 6 days for determining pain. Mouth opening was measured on the 1st, 2nd, and 7th postoperative days. Results: Maximal swelling was noted in both groups on the second postoperative day. In both groups, maximal trismus was noted on the first postoperative day. Approximately 98% of the measurements of interincisal distances had returned to the preoperative values by the 7th day. There was no significant difference in the pain intensity between the two groups on postoperative days 1 through 6. Swelling (P = .88) and pain (P = .12) were not significantly different in either groups. Trismus was found to be significantly less (P = .03) in the lingual split group. Conclusion: Although swelling and pain were comparable in both groups, the amount of trismus was less with the lingual split technique. This may be an advantage of the latter technique.