The use of small-diameter implants is indicated when small missing teeth have to be replaced, especially in esthetic zones. Nevertheless, the small diameter can pose a limiting factor with respect to what materials can be used for the final crown. In most cases, full-ceramic crowns in combination with a ceramic abutment are usually the material of choice for final reconstructions. To date, based on mechanical considerations, a 3.5 mm implant diameter has been a contraindication for using ceramic abutments. The authors describe here the development, in vitro testing, and clinical use of a zirconium abutment with a 3.5 mm diameter. The advantages of this small-diameter zirconia abutment include a minimum platform height that offers optimal prosthetic flexibility, and an accurate transfer of the implant position on to the master model. Furthermore, a precise rotational orientation for single-tooth restorations, optimal mechanical stability, and optimal fatigue resistance can be achieved. The microgap is minimized and protection against overload is afforded. In the reported case, high patient satisfaction was achieved due also to an esthetically pleasing final result.