One of dentistry's most basic and essential processes is administering a local anesthetic. Before beginning any procedure on patients, many clinical specialties in dentistry require the administration of a local anesthetic. Students may find it challenging to master optimal local anesthetic techniques as they demand refined technical skills to enable painless administration. Therefore, before administering their first injection, students must complete their educational requirements regarding knowledge and practice. Non-human objects, cadavers, simulation models, and student-to-student administration are some methods utilized for learning local anesthesia in undergraduate dental education institutions worldwide. Therefore, this study was conducted to evaluate and compare the learning outcome of students who under took the contemporary preclinical teaching program (lectures and clinical), shadowing a higherlevel student to administer the local anesthesia to the patient, to those who provide a modern teaching and learning program (lectures and preclinical simulation for a semester then lecture and clinical practice student to student in the 2nd semester), before practicing on the patient the following year. This study is retrospective longitudinal data gathered from the local anesthesia assessment sheets for 3rd, 4th and 5th undergraduate dental students and compared their marks before and after implementing the local anesthesia modern teaching method from 2018 to 2021. This study aims to determine whether a modern approach teaching program in local anesthesia delivery affects undergraduate dental students' perceived and actual learning outcomes.