Purpose: A prospective cohort multicenter study was undertaken to identify risk factors for implant survival, complications, and patient-centered outcomes following single-tooth immediate implant placement and loading in esthetic areas. Materials and Methods: Consecutive immediate implants placed in incisors, canines, and premolar sites were included. Variables recorded as possible risk factors included smoking habit, systemic conditions or therapies, previous assumption of bisphosphonates, inability to take amoxicillin, untreated periodontitis, thin periodontium, parafunctional habits, suppuration, bone dehiscences, and buccal bone fracture during implant insertion. Outcome variables included implant survival, recession, other complications, and patient satisfaction. Results: Data of 215 implants in 215 patients were collected in 15 centers in 2 years. One implant was seated with a torque 30 Ncm and was not immediately loaded. It was successfully loaded 10 weeks after placement and was healthy 2 years later. This implant was excluded from subsequent analysis. Potential risk factors were identified in 116 patients (54.21%). There were 11 dropouts after 1 year and 37 after 2 years. Failures were relatively frequent (14.6%) before the delivery of the definitive prosthesis. No significant association was observed between early failures and risk factors. One failure and six recessions were observed after the definitive prosthesis. High satisfaction scores (mean score of 9.47/10 and 9.55/10 for esthetics and function, respectively) were recorded at 2 years. No recession occurred in the no-risk group. Five mucositis cases and one peri-implantitis case were observed in the 2-year follow-up. Conclusion: Failures were frequent before the definitive restoration and could not be explained by specific risk factors. Tissues appeared stable after the definitive restoration. Patients were very satisfied during the follow-up. Keywords: cohort study, dental implants, esthetics, osseointegration, tissue preservation, tooth extraction