The contemporary oral and maxillofacial surgery practice should routinely treat failing teeth with immediate implants. This presentation will demystify the soft- and hard-tissue evaluation for the treatment planning of immediate implants in the esthetic zone. The various techniques for the fabrication of the immediate provisional will also be discussed. Immediate placements of implants in molar and premolar sites will also be reviewed. Understanding the role of implant micro and macro design is critical for achieving the insertion torque needed for immediate implant placement. Understanding site preparation and undersizing is also critical in order to consistently gain initial stability for immediate implants placed in the esthetic zone as well as the posterior quadrants. This presentation will also discuss the role of bone grafting including the pros and cons of autogenous allografts as well as xenografts.