Autogenous tooth transplantation (ATT) is a surgical technique to replace missing teeth by transplanting donor teeth from the same individual. While success rates are generally high (80 - 90%), intraoperative complications including sinus membrane perforation and infection may occur, particularly in the maxillary molar region. Incorporating maxillary sinus floor elevation can help minimize these risks, especially in cases involving sinus pneumatization. However, there is limited evidence supporting the feasibility of performing this technique simultaneously with sinus floor elevation in cases of insufficient residual crest height caused by sinus pneumatization. In the present case report, a 34-year-old female patient in need of bilateral first molar extraction visited the clinic. The treatment plan included the ATT of maxillary third molars into the fresh extraction sockets of the first molar sites, combined with simultaneous lateral sinus floor elevation. After 12 months follow-up, both transplanted molars were successfully maintained without showing any patient symptoms, presenting favourable outcomes in terms of clinical and radiographic parameters. This case report presents a promising option for replacement of maxillary molar teeth with significant sinus pneumatization, though further research with standardized protocols and long-term follow-up periods is needed.