Statement of problem: Zygomatic implants have been utilised for the treatment of the severely atrophic maxilla since 1998. However, few articles exist as to the success of zygomatic implants and immediate loading of its prosthesis. Aim: To systematically review the outcome of immediate loaded zygomatic implants. Materials and methods: An electronic PubMed search was performed to identify case reports, prospective and retrospective studies of immediately loaded zygomatic implants with a mean follow-up of 12 months. Assessment of the identified studies was performed using the Delphi method. Reviewers independently assessed the articles for inclusion, with a facilitator coordinating responses. A consensus was reached on the articles that were included. Results: The search provided 236 titles for immediately loaded zygomatic implants and resulted in 106 abstracts for analysis. Full-text analysis was performed on 67 articles, resulting in the inclusion of 38 articles for this systematic review. Conclusion: Based on the present systematic review, the authors report that immediately loading zygomatic implants for the restoration of the severely atrophic maxilla presents a viable alternative for treatment of the atrophic maxilla. Keywords: immediate load dental implant, zygoma, zygomatic implant