The Gow-Gates mandibular block, introduced in the United States in 1973, represents the first new approach to intraoral regional anesthesia in many years. The technique is being taught at most United States dental schools. This article presents a clinical evaluation of the Gow-Gates technique after 5 years of application and more than 4,000 cases. Advantages of this technique over the conventional inferior alveolar nerve block include a greater success rate, decreased positive aspiration rate, and fewer postinjection problems.