Purpose: This investigation aimed to evaluate clinical, prosthetic, and patient-based outcomes of a milled bar with polyether ether ketone (PEEK) and metal housings for inclined implants supporting mandibular overdentures. Materials and Methods: Eighteen edentulous participants received four implants in the interforaminal area of the mandible (two vertically and two distally inclined), and implants were connected with milled bars. Overdentures were attached to the bars with PEEK female housing (test group). The control group consisted of participants who received milled bar overdentures with conventional metal housings but were case matched to the test group and served as a historical cohort. Clinical parameters (Plaque Index, Gingival Index, pocket depth, and bone loss) were measured at baseline, 6 months, and 12 months. Patient satisfaction (using visual analog scale) and prosthetic complications were recorded after 12 months. Results: The control group showed a significantly higher plaque score and marginal bone resorption compared with the test group. The test group showed higher satisfaction with retention, stability, speech, and esthetics compared with the control group (P .048). The test group showed a significantly lower incidence of female housing wear (P = .017), plastic clip wear (P .001), and plastic clip fracture/renewal (P = .049) than the control group. No difference between groups was noted for other clinical, prosthetic, and patient-based outcomes. Conclusion: PEEK housing of a milled bar may be a successful alternative to conventional metal housing for inclined implants supporting mandibular overdentures, as it is associated with favorable clinical, prosthetic, and patient-based outcomes after 1 year. Keywords: computer-guided surgery, flapless procedure, inclined implants, overdenture, prostheses, randomized controlled clinical trial