To analyze the clinical effect and safety of hammer chisel split crown method and minimally invasive tooth extraction in the treatment of horizontally impacted mandibular wisdom teeth. Methods From February 2022 to September 2023, 80 patients with horizontally impacted mandibular wisdom teeth admitted to our hospital were randomly divided into control group and study group, with 40 patients in each group. The control group was treated with hammer chisel split crown method, and the study group was treated with minimally invasive tooth extraction. The clinical indexes, inflammation indexes, pain degree and complication rate were compared between the two groups. Results The operation time of the study group was shorter than that of the control group, and the intraoperative blood loss was less than that of the control group (P<0.05). After treatment, the levels of anti-PgIgG, IL-6 and TNF-α in the study group were lower than those in the control group (P<0.05). The VAS scores of the study group were lower than those of the control group on the 1st, 3rd and 5th day after operation (P<0.05). The incidence of complications in the study group was 2.50%, which was lower than 15.00% in the control group (P<0.05). Conclusion Minimally invasive tooth extraction has a definite clinical effect in the treatment of horizontally impacted mandibular wisdom teeth, which is beneficial to shorten the operation time, reduce the amount of intraoperative blood loss, improve the level of inflammatory factors, reduce the degree of pain and have fewer complications.