Purpose: A retrospective study on the performance of endosseous implants in a population of patients with severe epilepsy and additional motor and/or intellectual impairments was performed. Materials and Methods: All residents of an inpatient center for persons affected by severe, refractory epilepsy and multiple disabilities who received endosseous implants between 1991 and April 2007 were included in the study. Implant survival was analyzed using the Kaplan-Meier method. A subset of patients who were treated between 1991 and 2004 was invited to participate in a clinical and radiographic evaluation in 2004 and 2005. Results: A total of 61 patients were treated between 1991 and April 2007 (n = 134 implants). Three of these implants in three different patients failed during the observation period, demonstrating an estimated probability of functional implant survival of 97.6% (SE 1.4%) after 16 years. In patients who were seen during the clinical evaluation in 2004 (n = 76 implants), only mild inflammation of the peri-implant mucosa was generally observed (Gingival-Bleeding Index = 1), despite the fact that the level of oral hygiene was considered inadequate around 55 of 76 implants (72%). Obvious signs of drug-induced gingival hyperplasia in relation to the implants were not observed. Probing depths averaged approximately 2 mm. Stable marginal bone levels were observed on the radiographs. Conclusions: Dental implant treatment in a population of patients with severe epilepsy and additional disabilities seems to be a viable treatment option. Implant loss is rare. Although adequate plaque control was not feasible in all patients, marginal bone levels remained stable. Keywords: dental implants, epilepsy, retrospective study