Purpose: The purpose of this longitudinal study was to evaluate the success of bovine bone and calcium sulfate (CaSO4) as sinus augmentation material with osteotome maxillary sinus lift. Materials and Methods: Thirty-one osteotome sinus lift procedures were performed for 18 healthy patients (7 males and 11 females). A mixture of bovine bone and CaSO4 (ratio, 4:1) was used as sinus augmentation material with simultaneous implant placement. Implants were loaded 4 to 5months postimplant surgery. Cases were followed for an average of 23.4months postloading (range, 1260months). Results: The mean age of the study group was 49.7 +/- 10.66years. The residual height of the alveolar ridge ranged from 5.5 to 11mm (mean, 8.16 +/- 1.52mm). Four to 5months after implant placement, the x-ray showed a 1.5 to 5mm apical shift of the sinus floor (mean, 3.47 +/- 0.97mm), which was maintained to the end of the evaluation period. At 12months postloading, crestal bone loss ranged from 0.5 to 1.5mm (mean, 0.87 +/- 0.26mm), and pocket depth ranged from 2 to 4mm (mean, 2.9 +/- 0.67mm). No significant change in crestal bone loss or pocket depth was noticed afterward. Conclusion: Bovine bone plus CaSO4 can be used successfully as a sinus augmentation material with osteotome sinus elevation. The use of CaSO4 significantly improved the handling properties of bovine bone and helped to stabilize the bone graft particles during healing.