Objectives: To compare the clinical outcome of enucleation versus marsupialization followed by enucleation in managing unicystic ameloblastoma. Material and Methods: A retrospective chart review of 40 patients equally divided into marsupialization and enucleation groups was carried out. Pre and Post-operative clinical features and radiographic bone resorption volume were evaluated using SPSS version 22. The independent sample T-test was used to compare the mean ages of the two groups. Categorical variables were subjected to the Chi-square test or Fisher's exact test. A logistic regression model included the variables with p <0.05 to determine the odd ratios. Results: Data analysis showed male dominancy in the enucleation group (12, 60%) and marsupialization groups (11, 55%). The mean age was 31.35±SD7.0507 and 29.80 ±SD9.1450, respectively, for group 1 and group 2. Post-operative pain, paresthesia, and swelling predominated in the enucleation group. A good percentage of reduction in bone resorption was noted in the marsupialization group. A significant difference was observed between the groups in terms of Postoperative paresthesia, Postoperative Swelling, and % reduction in Bone resorption (0.050, 0.004, and 0.001, respectively). Conclusion: Conservative approach in the form of marsupialization showed less post-operative pain, paresthesia, and swelling as compared to the enucleation group. A good percentage of bone remodeling and less recurrence or progression of the disease was documented in the marsupialization group, resulting in a positive patient response to this strategy.