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Introduction: The placement of dental implants in posterior edentulous maxilla present one of the greatest challenge to the implant dentistry because of maxillary sinus pneumatization. Various sinus augmentation techniques have been used with impressive success rates aimed at developing these sites for implant placement. Knowledge of anatomy of maxillary sinus guides us not only in proper preoperative treatment planning but also helps us to avoid the possible complications that may arise during sinus augmentation procedure. Case presentation: In this case report, direct maxillary sinus elevation and augmentation was done with simultaneous implant placement in left maxillary quadrant. Conclusion: The present report suggests a protocol for direct maxillary sinus elevation in atrophic maxilla requiring implant treatment.