Purpose: A new approach for zygomatic implant placement was proposed to eliminate the risk of maxillary sinusitis related to the procedure. Materials and Methods: A prospective study of this new approach was conducted, and consecutive patients treated between June 2007 and December 2008 were included. An extended sinus lift with retained bone window was performed, such that zygomatic implants were placed completely outside the displaced maxillary sinuses. All patients were followed up radiologically at regular intervals using cone beam computed tomography to evaluate the status of the zygomatic implants and the condition of the maxillary sinuses. Results: Sixteen patients (9 women and 7 men with a mean age of 60) were treated with 37 zygomatic implants. Within the period of investigation from 6 months to 24 months, there were no failed zygomatic implants, and no instances of maxillary sinusitis were reported. Conclusions: The new approach that combined the zygomatic implant placement with the extended sinus lift procedure was predictable and fulfilled the purpose of lowering the risk of maxillary sinusitis. Keywords: bone regeneration, maxillary sinusitis, sinus elevation, sinusitis, zygomatic implants