Introduction: The sinus lift technique is a widely used procedure for the rehabilitation of the atrophic maxilla in terms of height in the posterior regions. Initially, it was performed through a lateral approach with an open window, until a less invasive procedure, the transcrestal elevation, began to be used. Today, this approach is almost exclusively performed, with the lateral approach being reserved for extreme atrophies (1–2 mm in height). Regarding graft material, there have also been modifications over time, evolving from block grafts and particulate autologous bone to mixtures of different materials, and more recently, to graft-free techniques. In these cases, only the pressure from the implant apex and space maintenance contribute to new bone formation within the augmented space. This article presents cases treated with transcrestal sinus lift without graft material, with a follow-up period of up to 15 years. Materials and Methods: Patients who had undergone a transcrestal sinus lift without graft material and had a minimum follow-up of 10 years and a maximum of 15 years were consecutively recruited. Follow-up evaluations were conducted every six months, assessing bone gain over the implant apex and its stability over time, as well as mesial and distal crestal bone loss and implant survival. Results: A total of 27 patients who received 45 implants meeting the inclusion criteria were recruited. Among them, 44.4% were women, with a mean age of 68 years (±4.5). The mean initial bone height at implant placement sites was 5.75 mm (±1.11), ranging from 2.07 to 7.10 mm. At the end of the follow-up period, which had a mean duration of 12.8 years (±1.32), ranging from 10 to 15 years, the final mean bone volume at the implant site (implant length + bone gain) was 8.99 mm (±1.91). The mean bone gain over the apex across all implants was 4.21 mm (±1.89). Regarding bone loss, the mean mesial crestal bone loss across all implants was 0.66 mm (±0.46), with a range of 0 to 2.21 mm, while the mean distal crestal bone loss was 0.87 mm (±0.53 mm), ranging from 0 to 3.03 mm. Conclusions: Transcrestal sinus lift without graft material, using short and extra-short implants along with a specific drilling sequence, is a safe and predictable technique, even in the long term. The results of this study, with a follow-up period of 10 to 15 years, support its effectiveness and reliability.