Maxillary transverse deficiency (MTD) can be treated with Minimally Invasive Surgically Assisted Rapid Maxillary Expansion (MISARME) to improve surgical outcomes in non-growing patients and increase patient satisfaction. The purpose of this study was to compare Surgically Assisted Rapid Maxillary Expansion (SARME) and MISARME in terms of patient outcomes, including blood loss, operation time, edema, pain, and nasal soft tissue changes. This randomized, double-blind clinical trial was conducted on patients who underwent SARME to treat MTD. The primary predictor variable was the type of the SARME technique: SARME or MISARME. The primary outcome was bleeding and operation time. Secondary outcomes were postoperative pain, edema, and nasal soft tissue changes. The study was completed with 35 patients. Blood loss and operation time were significantly higher in the SARME (68.61 ± 28.68 ml-45.27 ± 2.08 min) compared to the MISARME (52.05 ± 14.03 ml-23.82 ± 9.39 min) (P < .05). No statistically significant difference was observed in the mean alar base and nasal widths at any time point within the MISARME(P < .05), while a significant difference was found in the SARME(p > .05). The edema measured between the T1-T0 time points was significantly lower in the MISARME compared to the SARME(P = .002). According to these results, MISARME may improve patient outcomes and reduce undesirable changes in nasolabial soft tissues.