The purpose of this article is to demonstrate an alternative method for sinus augmentation through a palatal approach when complications do not allow the use of traditional approaches. A 50-year-old male patient presented with multiple previous sinus augmentation attempts. A cone beam computed tomography scan revealed bone graft material had consolidated on the buccal aspect of the lateral sinus wall only, preventing implant placement while not allowing access via a conventional lateral window technique to improve the graft bulk. A palatal approach was adopted as an alternative method of sinus entry and is presented in this case report. The authors suggest that a palatal approach technique is a safe and effective method to complete a sinus augmentation where a buccal approach is impractical.