Purpose: To analyze the long-term outcome of fixed prostheses supported by six implants, two of which were tilted, placed in the maxilla and immediately loaded more than 10 years earlier. Materials and Methods: A retrospective review of implants placed between May 29, 2003 and February 12, 2005 and used to support immediately loaded fixed dental prostheses in the maxilla was conducted. The features of failed implants were analyzed. In the most recent follow-up visits, survival of individual implants and prostheses was verified, and modified Plaque Index as well as modified Sulcular Bleeding Index were assessed. Patients also filled out a questionnaire requiring graded responses from 0 (poor) to 10 (excellent) that was designed to assess their quality of life. Results: A total of 162 implants were placed between May 29, 2003 and February 12, 2005 to support immediately loaded maxillary fixed prostheses of 27 totally edentulous patients (19 female, 8 male). Three patients (1 male, 2 female) dropped out, so 144 implants were followed up. Seven of the 144 original implants failed, corresponding to a survival rate of 95.1% over 10 years. All the failures occurred within 2 years after surgery. Patients' responses to the questionnaire produced an average score of 8.4 to 8.8, showing a relevant degree of satisfaction. Conclusion: Based upon this study of 27 patients who received immediately loaded maxillary full-arch fixed implant-supported prostheses supported by two tilted and four axial implants, it appears that this is a reliable procedure with a high long-term survival rate and a high level of patient satisfaction. Keywords: immediate loading, maxilla, tilted implants, 10-year follow-up