Aim: Rehabilitation of the edentulous atrophic maxilla by implants to allow placement of a fixed dental prosthesis remains a challenge, especially if immediate function is provided. The aim of this retrospective study was to evaluate the success rate of immediately loaded zygomatic implants placed in atrophic maxillae. Materials and methods: Forty-two consecutively treated patients (19 men and 23 women), with a mean age of 57 years (range: 34 to 79 years) were followed for at least one year (range: 12 to 42 months, mean: 20.5 months). Thirty-seven patients were totally edentulous and five were partially edentulous. In total, 81 zygomatic and 140 conventional implants were inserted. The success criteria for the zygomatic implants were: (1) confirmed individual implant anchorage to the zygomatic bone by means of anteroposterior cranial radiograph; (2) the implant acting as an anchor for the functional prostheses; (3) no suppuration, pain, or ongoing pathological process at maxillary and zygomatic level; (4) confirmed individual implant stability. All patients had a fixed prosthesis screwed onto implants within 48 hours of implant placement. Descriptive statistics were used to analyse the data. Results: After one year, there was no patient drop-out. None of the zygomatic implants were lost over the observation period (100% success rate). Four conventional implants were lost, resulting in a success rate of 97%. All the prostheses were stable. Oroantral fistula and sinusitis was found in one patient, which was solved with antibiotics and meatotomy, with no further complications. Soft tissue swelling and pain at the zygomatic area were found in another patient after 10 days of surgery. This was solved with antibiotics, with no further complications. Conclusions: Zygomatic implants together with conventional implants in severely resorbed maxillae appear to be a reliable technique for providing immediate function to patients. The time of treatment can be substantially decreased in a predictable way if zygomatic implants are loaded immediately after placement. Schlagwörter: immediate loading, zygomatic implants