The use of a hydropneumatic balloon for the elevation of the sinus membrane is a new technique for sinus floor augmentation procedures. Few cases using such a technique are reported in the English medical literature. This report describes 40 patients who were treated with this technique and studied retrospectively. Forty consecutive patients with an alveolar crest-sinus floor distance (bone height) = 12 mm were enrolled. Under microscopy (40×) and using piezosurgical instruments, hydropneumatic sinus membrane elevation was performed, and a calcium sulphate solution was injected under the elevated antral membrane using a syringe. In the same surgical session, 4.00- to 6.50-mm-diameter implants were placed. Bone height at 12 months, complications related to the surgical technique, and implant failure were all recorded. Bone height at 12 months was 14.66 ± 1.48 mm, with a sinus membrane elevation of 9.01 ± 3.01 mm. Fifty-six implants were placed, and no failures were observed after 1 year. One macrolaceration and two microlacerations were the only complications related to the technique. Minimal invasiveness and reduced trauma characterize this new approach. In fact, gradual balloon inflation provides a controlled and atraumatic preparation of the sinus floor membrane. Piezoelectric instruments and microscopy make this technique predictable and safe. The relatively short learning curve of this approach for sinus floor elevation allows for its use in private practice.