Piezosurgery is the current advanced technology used in bone cutting, which enables a selective cut of mineralized tissue while being cautious of the soft tissue. Previously used for osteotomies and for harvesting bone grafts, piezosurgery is more recently used for sinus augmentation and third molar surgeries. Removal of third molars is the most common surgery performed by a maxillofacial surgeon. Successful removal of the third molar depends on an appropriate osteotomy, for which many techniques have been advocated. These techniques include usage of rotatory, chisel and mallet, and recently introduced piezoelectric technique. The innovation of piezoelectric surgery has created an opportunity for precise and safe osteotomies. Post-operative sequelae and complications related to extraction of third molars include pain, trismus, edema, alveolitis, secondary infections, intra-operative nerve injury and bleeding. To reduce the post-operative discomfort, pre-operative antibiotics, variations in flap design and osteotomy methods have been employed. Piezosurgery and conventional techniques both have been routinely used in the surgical management of third molars. This article reviews previous literature on application of piezosurgery in third molars.