This technical note describes a new surgical technique for a palatal approach to the maxillary sinus for a vertical augmentation prior to dental implant placement. In 12 fully or partially edentulous patients (seven women, five men), 16 palatal sinus elevations were performed. After elevation of palatal full-thickness flap a rectangular access window was cut with a piezosurgical device. The raised sinus cavity was augmented with a synthetic nano-structured hydroxyapatite-based graft material. No harm occurred to the greater palatine artery or the sinus membrane. The vestibular and periimplant gingiva were preserved and there was no disharmonious soft tissue distortion or massive scar formation. Swelling and bleeding were minimal. Primary stability was achieved for all but one implant. This technique may be an alternative to other sinus augmentation approaches in cases where enough transversal width of the posterior alveolar crest is available.