Abstract Objective To compare different temporomandibular joint (TMJ) arthrocentesis techniques with needles arranged in two different patterns. Materials and methods Two groups of TMJ arthrocentesis techniques were studied: group 1, with the classic positioning of the needles; and group 2, with a parallel positioning of the needles. Clinical data (patient’s pain perception and mandibular movements) were evaluated before and 18 months after arthrocentesis. The duration of the procedure was also recorded. Results Forty patients were equally and randomly divided into the two groups. The paired Student’s t-test showed that both arthrocentesis procedures reduced the intensity of patient pain perception and improved mandibular movements (maximal interincisal distance, protrusion, and laterality) with statistically significant differences between the evaluations before and after the TMJ arthrocentesis (p Conclusion Both arthrocentesis procedures reduced the intensity of patient pain perception and improved mandibular movements. The two-needle TMJ arthrocentesis with parallel positioning of the second needle was performed more quickly, and should be chosen whenever possible.