Purpose: To evaluate the peri-implant soft and hard tissues of dental implants placed in vertically regenerated posterior mandibles with intraoral onlay block bone grafts and patient satisfaction at 3-year follow-up. Materials and Methods: A retrospective study of patients with dental implants placed in posterior mandibular sites vertically augmented with intraoral onlay block bone grafts was carried out between 2005 and 2009 at the University of Valencia. The outcomes assessed at the 3-year follow-up visit were the peri-implant soft tissues (Plaque Index and Bleeding Index, probing depth, keratinized mucosa width, and recession), implant survival and success rates, marginal bone loss, and patient satisfaction. Results: Sixteen patients with 36 implants were included. The mean Plaque Index and Bleeding Index scores were ≤ 0.4. The mean band of facial keratinized mucosa was ≥ 3 mm in 52.7% of implants; 38.8% of the implants showed facial recession. The mean midfacial recession was -0.31 ± 0.75 mm. Implant survival reached 100%, while the success rate was 85%, and the mean marginal bone loss was 1 ± 1.03 mm (range: 0.1 to 5.3). Good quality of life (9.19 ± 0.40) was reported for all patients, and the overall general satisfaction score was 8.07 ± 1.04 (mucosa esthetics: 7.71 ± 1.45; prosthesis esthetics: 8.42 ± 0.6; chewing: 8.68 ± 0.94; ease of cleaning: 8.01 ± 1.03). Conclusion: Considering the limitations of the study, implants in vertically augmented posterior mandibular areas with intraoral onlay block bone grafts showed good soft tissue levels and high patient satisfaction. No implants were lost at 3 years postloading, though one-fifth of the patients showed a statistically significant marginal bone loss. Keywords: atrophied mandible, block bone graft, intraoral graft, onlay graft, soft tissues, vertical augmentation