Intramuscular (IM) sedation techniques remain the least used by clinicians, possibly because of their limited exposure in the undergraduate and graduate dental curricula. To assess the safety and efficacy of these techniques, the authors conducted a retrospective study of 900 dental cases. A total of 308 patients received ketamine, 356 received a meperidine/promethazine combination, and 236 received midazolam. Results revealed a high safety record, efficacy, and good evaluations from clinicians and patients, in addition to some advantages over other sedation techniques.