Newman and Friedman proposed a new technique using extraoral approach to take periapical radiographs in certain patients who can’t tolerate film or sensors inside their mouth. Here we are presenting some cases using extraoral periapical approach for patients with trismus, patient having gag reflex and pediatric apprehensive patients in which use of intraoral periapical radiography is not possible. This technique can be used as alternative to intraoral periapical technique in certain patients with comparable diagnostic value but can’t replace it in routine dental practice. Aims: To evaluate diagnostic importance Extraoral periapical radiographic technique Settings and Design: Observational study Methods and Material: The study was conducted in oral radiology department using Bio-Dent-1070 D (Biodent Bio medicare Imaging) dental x-ray unit; 70 kvp, 10 mAs, 0.03-0.05 sec, 2mm aluminum filtration. Results: The radiographs obtained by extraoral periapical radiographic method showed satisfactory diagnostic quality as compared to conventional intraoral radiographs Conclusions: Extraoral periapical technique can be advisable in certain situations where intraoral use of films or sensors are not possible but it can’t replace conventional intraoral periapical technique. More standardization is recommended to get better diagnostic images in this technique.