Objective To explore the effects of ultrasound bone knife on surgical indicators, postoperative pain, and complications in the extraction of mandibular low impacted wisdom teeth. Methods A total of 61 patients with mandibular low impacted wisdom teeth on both sides （a total of 122 mandibular low impacted wisdom teeth） admitted from August 2022 to October 2023 were selected for the study. They were randomly divided into a control group of 30 cases and an observation group of 31 cases, using traditional bone chiseling and crown chopping methods for extraction and ultrasonic bone knife methods for extraction, respectively. The inflammatory mediators, oxidative stress mediators, surgical time, intraoperative bleeding volume, postoperative pain [visual analogue scale （VAS） score], and complications were compared between the two groups. Results After surgery, the interleukin （IL）-1β, IL-6 and malondialdehyde （MDA） levels were lower in the observation group than in the control group, while the superoxide dismutase （SOD） and glutathione peroxidase （GPx） were higher （P<0.05）. The observation group had lower surgical time, bleeding volume, VAS scores at 6 and 24 h after surgery, and postoperative complication rate than the control group （P<0.05）. Conclusion The application of ultrasound bone knife in the extraction of mandibular low impacted wisdom teeth can shorten the surgical time of patients, reduce intraoperative bleeding, improve inflammatory mediators and oxidative stress mediators, alleviate postoperative pain, and reduce the incidence of complications, which is worthy of recognition.