Purpose: The aim of this study was to evaluate the clinical and radiographic outcome of dental implants immediately placed and loaded into fresh extraction sockets after 18 months. Materials and Methods: Twenty-seven patients, 15 women and 12 men, received a total of 160 implants; 150 were placed immediately after extraction. The sockets in the study had fully preserved walls, and 10 were placed in healed sites. Immediately after surgical procedure, all patients received the temporary prosthetic reconstruction in occlusion. Five months postsurgery, definitive metal-ceramic restorations were cemented on abutments. Follow-up visits were performed for the assessment of clinical parameters. Intraoral digital radiographic examinations were performed 3 and 18 months after implant placement. Results: Minor swelling of the gingival mucosa was observed, but no mucositis or flap dehiscence with suppuration were found. Mean marginal bone loss 1 year 18 months after immediate loading was 0.65 ± 0.58 mm to the mesial side and 0.84 ± 0.69 mm to the distal side in the maxilla and 1.13 ± 0.51 mm mesially and 1.24 ± 0.60 mm distally in the mandible. There was no difference between splinted and nonsplinted implants with respect to marginal bone loss. Discussion and Conclusion: Within the limits of this clinical study, the results indicate that immediate loading of implants placed in immediate extraction sites can be carried out successfully. (Case Series) Keywords: fresh extraction socket, immediate implants, immediate loading