This study was conducted to compare the effectiveness submucosal dexamethasone and tube drain on postoperative sequelae following surgical extraction of impacted mandibular third molars. 20 patients who visited for surgical extraction of bilaterally impacted mandibular third molars are taken. All the patients included in the study received dexamethasone injection on one side (Group 1) and tube drain on the contralateral side (Group 2). A minimum of two weeks interval was given between the bilateral surgical procedures in all the individuals. Pain, swelling and trismus were recorded on 2nd and 7th post-operative days and the collected data was subjected to statistical analysis using Mann-Whitney test and t test. Results of the present study showed that there was no statistically significant difference in facial swelling and trismus between Group 1(dexamethasone) and Group 2 (tube drain) on both 2nd and 7th post-operative days. This study showed that group 2 experienced more pain compared to group 1 and the difference in pain experience is statistically significant on both 2nd and 7th post-operative days. Our study showed that the 4 mg of submucosal dexamethasone is more effective than tube drain in reducing post-operative sequelae after surgical extraction of impacted mandibular third molar. Based on our clinical experience and study results we would like to conclude that submucosal dexamethasone should be preferred over tube drain in patients undergoing surgical extraction of impacted mandibular third molars to minimize post-operative sequelae. Further we recommend use of tube drain in clinical situations like completely impacted tooth, presence of infection or risk of infection because of systemic disorders and patients in whom steroids are contraindicated.