Purpose: The purpose of this study was to compare the three-dimensional accuracy of indirect plastic impression copings and direct implant-level impression copings from three implant systems (Nobel Biocare [NB], Biomet 3i [3i], and Straumann [STR]) at three interimplant buccolingual angulations (0, 8, and 15 degrees). Materials and Methods: Two-implant master models were used to simulate a three-unit implant fixed partial denture. Test models were made from Impregum impressions using direct implant-level impression copings (DR). Abutments were then connected to the master models for impressions using the plastic impression copings (INDR) at three different angulations for a total of 18 test groups (n = 5 in each group). A coordinate measuring machine was used to measure linear distortions, three-dimensional (3D) distortions, angular distortions, and absolute angular distortions between the master and test models. Results: Three-way analysis of variance showed that the implant system had a significant effect on 3D distortions and absolute angular distortions in the x- and y-axes. Interimplant angulation had a significant effect on 3D distortions and absolute angular distortions in the y-axis. Impression technique had a significant effect on absolute angular distortions in the y-axis. With DR, the NB and 3i systems were not significantly different. With INDR, 3i appeared to have less distortion than the other systems. Interimplant angulations did not significantly affect the accuracy of NBDR, 3iINDR, and STRINDR. The accuracy of INDR and DR was comparable at all interimplant angulations for 3i and STR. For NB, INDR was comparable to DR at 0 and 8 degrees but was less accurate at 15 degrees. Conclusions: Three-dimensional accuracy of implant impressions varied with implant system, interimplant angulation, and impression technique. Keywords: accuracy, implant impression, plastic coping, three-dimensional