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Aim The aim of this study is to evaluate the efficacy of sublingual piroxicam as a preemptive analgesic agent in patients undergoing single implant surgery. Materials and methods This was a prospective triple-blind placebo-controlled trial that involved 40 patients presented for the placement of a single endosteal implant in the posterior maxillary arch. Patients were randomly allocated to one of the following groups. Group I (study) who received sublingual piroxicam 40 mg 1 hour prior to the surgical procedure and group II (control) received placebo 1 hour before the surgery, both the groups received sublingual piroxicam 20 mg tablet twice a day on the first and the second postoperative day and once a day on the postoperative day 3. Visual analog scores for measuring pain intensity were assessed at postoperative 1 hour, 6 hours, days 1, 3, and 5. Facial swelling was measured and evaluated during the first, third, and fifth postoperative days using the digital vernier caliper. The Mann-Whitney U test was used to make between-group comparisons. The Wilcoxon-signed rank test was used to make within-group comparisons. Results At all-time intervals, both mean pain and mean swelling scores were higher in controls as compared with those of cases. The difference between the two groups was also statistically significant at all-time intervals for both parameters except for pain at 1 hour. Conclusion Our findings suggest that preoperative sublingual piroxicam is more effective for controlling postoperative pain and swelling after surgical implant placement than only postoperative administration.