Purpose: The aim of this prospective clinical study was to assess the risk factors associated with failure of mini-implants used for orthodontic anchorage. Materials and Methods: A total of 140 miniimplants in 44 patients, including 48 miniplates and 92 freestanding miniscrews, were examined in the study. A variety of orthodontic loads were applied. The majority of implants were placed in the posterior maxilla (104/140), and the next most common location was the posterior mandible (34/140). Results: A cumulative survival rate of 89% (125/140) was found by Kaplan-Meier analysis. There was no significant difference in the survival rate between miniplates and freestanding miniscrews, but miniplates were used in more hazardous situations. The Cox proportional-hazards regression model identified anatomic location and peri-implant soft tissue character as 2 independent prognostic indicators. The estimated relative risk of implant failure in the posterior mandible was 1.101 (95% confidence interval, 0.942 to 1.301; P = .046). The risk ratio of failure for implants surrounded by nonkeratinized mucosa was 1.117 (95% confidence interval, 0.899 to 1.405; P = .026). Discussion and Conclusion: The results confirmed the effectiveness of orthodontic mini-implants, but in certain situations adjustment of the treatment plan or modifications in the technique of implant placement may lead to improved success rates.