Immediate implant placement in esthetic area is a challenging surgical procedure. In the anterior maxilla, the esthetic outcome and the tissues stability over time is highly emphasized. A thorough preoperative analysis of the local site anatomy is essential to choose the most suitable surgical and prosthetic protocol. Due to the heterogenous data from the literature, a diagnostic algorithm was developed to assist the clinician in the decision-making process for single-tooth implant rehabilitation in the anterior maxilla. The treatment options were based on the predictability of implant primary stability, integrity of the buccal bone wall, gingival phenotype, and absence or presence of gingival recessions. Within its limitations, this approach may reduce the incidence of complications and failures.