This retrospective study investigates the efficacy of the socket shield (SS) in preserving inter-implant papilla and bone in anterior adjacent implant sites. Clinical and radiographic records of 23 patients were evaluated. A total of 31 implants were placed immediately into extraction sockets with SS, resulting in 26 inter-implant sites, and 7 implants were placed without SS. After a mean follow-up of 41.5 months (range: 12 to 124 months), 30/31 (96.8%) implants with SS and 7/7 (100%) implants without SS were clinically successful. The mean changes in inter-implant papilla and bone heights were –0.40 mm and –0.46 mm, respectively. The effects of implant placement timing and the socket shield number, shape, and crestal level on inter-implant tissue height changes were found to be insignificant (P > .05). Supracrestal shield level (31.6% vs 16.6% in equicrestal), U-shape shield (41.2% vs 7.1% in C-shape), and shield-to-implant contact (40.0% vs 12.5% in no contact) were associated with increased occurrence of exposures. The application of SS in adjacent anterior implant situations is a viable treatment option for maintaining inter-implant papilla.