Background of the study: Oro-antral communication is a complication associated with extraction of maxillary posterior teeth, surgeries of the maxillary sinus or pathologies associated with the sinus or the posterior maxilla. Such abnormal communications need to be repaired at the earliest, to maintain oral and nasal complex harmony and to prevent undue complications thereafter. These communications can be repaired by various methods, one of those being buccal fat pad pedicled graft technique which will be clinically evaluated and critically discussed in this paper. The pre-operative, immediate and post-operative measures followed, the eligibility criteria chosen and the duration of follow up period will formulate the outline for the study. A careful assessment of the criteria, clinical signs and healing is noted, to establish the outcome of the technique. Aim: The aim of this clinical study is to evaluate the effectiveness of buccal fat pad pedicled graft technique for closure of Oro-antral communications. The purpose of choosing this method is easy availability of the graft near to the recipient site, ease of technique for the surgeon, reliable technique and predictable outcome of the treatment. The effectiveness of the procedure and its predictability, in comparison to other methods is dealt in detail below. Methods: An observational study to evaluate the effectiveness of a surgical technique to repair oro-antral communications wherein the pedicled buccal fat pad is used as a graft material. 20 patients with OAC, who were presented to the department of Oral & Maxillofacial surgery, VS Dental College & Hospital, Bangalore were recruited for the study. The clinical study was conducted in accordance with the protocol and the results were evaluated on the basis of patient’s comfort towards the procedure, ease of the technique, healing time, post-operative complications and recurrence rate of the communication. The details of the technique and a review of the previous studies published were discussed in detail, to form a relevant summary. Results: The technique was found to be more effective and convenient to both the patient and operator, owing to its ease of performing, minimal risk of complications from the grafted site and the harvest site and predictable healing. Conclusions: The technique is easiest among the various methods recommended so far, pertaining to the procedure and predictability. Although, the training and experience of a skilled operator is equally important in achieving the best results.