OBJECTIVE To evaluate the clinical and radiographic outcomes of placing dental implants in the posterior maxilla using the transalveolar technique. METHODS Between January 2005 and December 2009, a total of 94 cases, 55 males and 39 females, aged (46.9 ± 11.8) years, were consecutively enrolled in this study with maxillary sinus floor augmentation using the transalveolar technique. Radiographic evaluations were conducted on panoramic and periapical radiographs at each recall. The follow-up clinical examination included cumulative survival rate(CSR) of implants, peri-implant marginal bone loss (MBL) and the height of sinus floor augmentation and the endo-sinus bone gain (ESBG). RESULTS Sinus membrane perforation was found in 4 cases.Finally 126 implants (90 cases) were placed. The perforation rate of this surgical procedure was 3.08% (4/130).Four implants lost during the healing time, the early success of implants was 96.80% (121/125). During a mean follow-up time of (34.4 ± 20.4) months, all the implants were successfully in function, with the cumulative survival rate after function loading of 100.00%. The mean MBL was (0.75 ± 0.51) mm during the healing time, and (0.48 ± 0.41) mm during the follow-up period. The mean residual bone height (RBH) was (7.27 ± 1.30) mm at the position of implants placement, the length of implant protruding into the sinus was (2.77 ± 1.15) mm, and the height of sinus floor augmentation was (4.52 ± 1.39) mm. At the loading time, the mean endo-sinus bone gain was (3.81 ± 1.60) mm. After the follow-up time of 34 months, the newly formed bone on the maxillary sinus floor underwent further remodeling with a median bone reduction value of 0.37 (0.10, 0.88) mm. CONCLUSIONS Maxillary sinus floor augmentation using the transalveolar technique is a predictable treatment modality. The augmentation of the maxillary sinus floor using the transalveolar technique could lead to bone formation under the sinus. The newly formed bone showed slight absorbtion in the long term follow-up.