Objectives: Extraction of teeth can be either uneventful and uncomplicated, or difficult, with considerable postoperative pain. Fear of a dental injection and postoperative pain can prevent patients from seeking dental care and often this fear is related to the feeling of needle penetration and pain during the injection. Local anesthesia plays an essential role in making dental treatment comfortable. The common techniques for providing pulpal anesthesia in maxillary molars include posterior superior alveolar (PSA) nerve block and infiltration anesthesia. The aim of this study was to compare the efficacy of two anesthesia methods for the extraction of maxillary molars: PSA nerve block technique vs local infiltration technique. Materials and methods: The present study was conducted to evaluate the efficacy of PSA nerve block technique and infiltration technique for extraction of maxillary molars. In our study total sample size was 40 who underwent extraction of maxillary molars age ranged between 18 and 30 years. They were divided into 2 groups 20 patients who underwent extraction under infiltration and 20 patients who underwent extraction under PSA. Patients who were healthy and non-Smokers having no medications and were free from active local inflammatory lesions, were included in the study. Before the commencement of study, patients were informed about the study and informed consent was taken before extraction. The palatal injection was combined to both techniques. Preoperative pain assessed by a professional operator who was different from the surgeon who performed the extraction. Each record was repeated three times on every case: during the injection, at the end of operation and after 15 minutes from the end of operation by using visual analogue scale. The data was analyzed using SPSS version 22. The pain VAS scores were analyzed by analysis of variance (ANOVA). Results: In our study total participants were 40 in which maxillary molar extraction was done. Patients with weak pain intensity during injection was more in infiltration 22.5% than PSA. Patients with no pain at the end of operation was more with PSA (32.5%). Patients with no pain after 15 minutes of the procedure was more with PSA (42.5%). Frequency of injection was less in PSA than compared to infiltration. Conclusion: Within the limitations of the study, the statistical analysis of the results confirmed the extraction of maxillary molars with PSA nerve block and infiltration technique with the mean advantages of PSA with Minimum number of necessary injections and patients with no pain at the end of operation and after 15 minutes from extraction was more with PSA however the risk of a potential complication also must be considered whenever the PSA block is used.