This study evaluated the effects of vascular photobiomodulation (VPBM) on pain intensity, edema, and facial temperature variation in patients undergoing alveolar bone grafting (ABG) surgery. A total of 42 patients with cleft lip and palate (aged 9-25 years) scheduled for ABG using iliac crest bone were randomly assigned in equal numbers (14 per group) to one of three groups: control (ABG only), test (ABG + VPBM), and placebo (ABG + simulated VPBM). Iliac and facial pain and edema were clinically evaluated 24 h post-surgery, along with thermographic facial analysis. Follow-up was conducted via phone calls for one week. No statistically significant differences were observed among the groups regarding facial pain and edema at 24 h post-surgery. However, iliac pain significantly differed between the placebo and control groups ( = 0.045). A significant time-related effect on both facial and iliac pain outcomes was noted during follow-up, irrespective of the group. The need for rescue medication and self-perception of reduced edema did not differ significantly. Thermographic analysis reveals a significantly lower temperature variation in the test group (2.36 °C) compared to the other groups ( = 0.007). Overall, VPBM therapy influenced postoperative pain in the early recovery phase and temperature in the immediate postoperative period but did not significantly affect edema.