Purpose: To report on the clinical outcome of 150 extrasinus zygomatic implants placed lateral to the maxillary sinus and combined with conventional implants in the anterior maxilla for the implant-supported rehabilitation of the edentulous maxilla. Materials and Methods: All patients included in this study presented with completely or partially edentulous maxillae with any remaining teeth indicated for extraction. Indications for extractions in partially edentulous patients included longitudinal fractures, periodontal disease, endodontic failure, perforated roots, and prosthetic convenience. All patients showed severe resorption of the posterior maxilla. Each patient was treated with at least four implants, with a minimum of one zygomatic implant. No bone grafting was performed. The zygomatic implants were placed outside the sinus, lateral to the maxillary sinus. The patients were followed with standardized clinical and radiographic examinations. Results: Seventy-five patients with severely atrophic maxillae (mean age, 52 years) were treated between 2003 and 2006. In all, 436 implants (150 zygomatic implants and 286 conventional implants) were placed. Two conventional implants failed during the study period, and two zygomatic implants were removed. All the prostheses were successful. No patients presented sinusitis. No loosened or fractured screws on any implants were recorded. Conclusion: Extrasinus zygomatic implants, when combined with conventional implants in the anterior maxilla, represent a predictable treatment option for the atrophic edentulous maxilla. Further studies are necessary to evaluate the long-term prognosis of these implants. Keywords: atrophic maxilla, dental implants, maxillary sinus, zygomatic implants