BACKGROUND: Video-based educational tools are becoming more commonly used among medical professionals to deliver instructions to patients. However, no studies have assessed patients' compliance with and understanding of post-operative instructions provided in the form of a video after tooth extraction. Therefore, this study aimed to evaluate the effectiveness of two post-extraction instruction delivery methods (conventional versus video-based instructions) on patients' understanding of and compliance with post-operative care following dental extraction. METHODS: This randomized controlled trial assessed patients who had undergone dental extraction at the dental teaching hospital at Umm Al-Qura University, Saudi Arabia. Patients were randomly assigned to two groups: the conventional group (n = 68) received written instructions, and the interventional video group (n = 58) was provided with instructions delivered in a video. Patient compliance and understanding of post-operative instructions after extraction were assessed via a questionnaire after two days. The questionnaire comprised three parts: the first part collected demographic data, the second part evaluated the patient's understanding of the post-operative instructions and the third part measured the patient's compliance with the post-operative instructions via close-ended questions. The collected data were analyzed via descriptive statistics and chi-square tests. RESULTS: This study involved 126 patients randomly divided into two groups: the conventional group (n = 68) and the video group (n = 58). The analysis of the questionnaires revealed no significant difference between the groups in terms of patient adherence to the post-extraction instructions. CONCLUSION: Post-operative instruction videos are as effective as the conventional method in helping patients understand post-operative instructions after extraction. TRIAL REGISTRATION: This randomized controlled trial was registered at the ISRCTN registry with the study registration number ISRCTN11048490.