Purpose: This study evaluated the 5-year clinical and radiographic performance of fixed implant-supported maxillary prostheses with either welded titanium or conventional cast- gold alloy frameworks. Materials and Methods: Fifty-eight consecutive patients were provided with 349 osseointegrated Brånemark system implants in the edentulous maxilla at six different implant centers. Twenty-eight of the patients received, at random, prostheses with laser-welded titanium frameworks, and the remaining 30 patients had prostheses with conventional cast-gold alloy frameworks. Clinical and radiographic data were collected for 5 years after prosthesis placement. Results: The titanium and cast-gold framework groups exhibited similar cumulative survival and success rates (CSR). The 5-year implant CSR from time of placement was 91.4% and 94.0%, respectively, and from prosthesis delivery the rate was 94.9% and 95.6%, respectively. The corresponding 5-year prosthesis CSRs were 96.4% and 93.3%. One patient from each group lost all the implants and turned to complete dentures within the first year of function. Another patient with a cast-gold framework had the prosthesis replaced after 4 years, basically because of problems with the veneering material. No fractures of implant components were observed during the follow-up period. Bone loss was on average 0.59 mm (SD 0.97 mm) during 5 years, with no statistical difference between the two groups. Conclusion: Welded titanium frameworks presented a similar favorable clinical performance as conventional cast-gold alloy frameworks in fixed implant-supported prostheses in the edentulous maxilla after 5 years in function. Implant failures were concentrated in only a few patients in each study group.