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BACKGROUND High primary implant stability is considered one of the main factors necessary for achieving predictable treatment outcomes with immediately loaded implant-supported screw-retained fixed complete denture prosthesis (FCDP). PURPOSE To evaluate the 5-year clinical and radiographic outcomes of immediately loaded implants placed in edentulous patients using computer-assisted template-guided surgery to support a FCDP. MATERIALS & METHODS Patients in need to be restored with a FCDP in the mandible or maxilla were included in this prospective study/ and treated using computer-assisted template-guided surgery. Implant sites were prepared in order to achieve an insertion torque ranging between 35-45 Ncm in the mandible and 45-55 Ncm in the maxilla. A prefabricated screw-retained provisional prosthesis was delivered the day of the surgery. Outcomes were: implant and prosthesis cumulative survival rate (CSR), any complications, and peri-implant marginal bone loss (MBL). RESULTS Sixty-six patients received 356 implants to support 68 FCDPs. Each patient received 4-8 implants. Seven implants failed in six patients, resulting in a CSR of 98.1%. Two definitive prostheses failed resulting in CSR of 97.1%. Mean MBL of 1.62 ± 0.41 mm was reported at the 5-year follow-up. Five implants (1.4%) showed a mean mesio-distal peri-implant bone loss greater than 3.0 mm and received nonsurgical therapy. CONCLUSIONS immediately loaded implants placed in edentulous patients using computer-assisted template-guided surgery to support a FCDP is a valid treatment concept in the medium term follow-up, for edentulous patients.