This study aimed to estimate the radiographic outcomes of the alveolar ridge splitting (ARS) technique combined with guided bone regeneration (GBR) and compare its efficacy with GBR alone in maxillary anterior narrow ridges. Forty patients with 51 implants in the ARS group and 40 patients with 49 implants in the GBR group were included. The buccal bone thickness (BBT) at 0 to 4 mm from the implant shoulder immediately and 6 months postoperative were analyzed using cone beam computed tomography. The BBT at both time points had no statistical disparities between the two groups (P > .05). However, BBT changes indicated significant disparities, with more BBT preservation in the ARS group (P < .05). Compared with GBR alone, the ARS technique combined with GBR, despite obvious buccal bone diminution, could be a reliable modality for treating ridge width deficiency in the anterior maxilla.