Oro-antral communication is an abnormal connection between the maxillary sinus and the oral cavity. This communication can occur due to pathological or non-pathological reasons. However, it is more common after the extraction of the maxillary posterior teeth which have their root tips close or attached to the maxillary sinus. Spontaneous healing is usually seen in OAC with less than 2mm in diameter. However, in case the OAC is more than 3mm a surgical treatment is usually considered to avoid further complications such as sinusitis. In this review, we will illustrate the appropriate diagnosis of the OAC and discuss all the surgical options for the closure of the OAC including the local flaps with the advantages and disadvantages of each technique.