Purpose: The aim of this prospective cohort study was to determine the 5-year implant survival and success rates associated with early loading (6 weeks after nonsubmerged placement) of sandblasted and acid-etched (SLA) Straumann implants in the edentulous mandible. A secondary objective was to determine the peri-implant tissue response and measure alterations in peri-implant crestal bone levels. Materials and Methods: SLA implants were placed and primarily loaded 6 weeks later with 35 Ncm during abutment placement. The peri-implant bone and mucosal conditions of the participants were monitored radiographically and clinically over a 5-year period. Results: Fourteen patients received 60 implants. Thirteen patients and 54 implants were examined at the 5-year appointment. Two of 60 implants failed during the healing period, and four implants were lost during follow-up and considered as dropouts. The remaining implants showed favorable clinical and radiographic findings and were considered successfully integrated at the 5-year examination. The mean loss of crestal bone height after 5 years was 0.77 mm (SEM 0.09). This resulted in a 5-year cumulative success rate of 96.7%. Conclusion: In this prospective study, the early loading of Straumann implants with the SLA surface in the edentulous mandible after a healing time of 6 weeks provided successful osseointegration with high predictability. Successful integration was maintained for 5 years. Keywords: dental implant, early loading, edentulous mandible, surface properties