Objective: To determine if the use of panoramic radiographs is a reliable method of predicting maxillary sinus membrane exposure or perforation during extraction of maxillary teeth. Method and Materials: The radiographs of 72 patients were evaluated before extraction of maxillary teeth, and a prediction was made whether exposure or perforation of the sinus membrane was likely. This decision was based on the proximity of the root tip to the radiographic floor of the maxillary sinus. The extraction site was then evaluated to determine if the sinus membrane was visible or if a perforation had occurred. Results: Possible exposure or perforation of the maxillary sinus was predicted in 27 patients. In this subset of patients, it actually occurred 4 times (14.8%). However, it also occurred 5 times when not predicted (11.0%). Conclusion: Use of panoramic radiographs is not a reliable method to predict the likelihood of sinus involvement following the extraction of posterior maxillary teeth. Keywords: extraction, maxillary sinus, panoramic radiography, sinus perforation