Purpose: The aim of this study was to compare the 5-year outcome of immediate loading with that of conventional loading for anterior single-tooth implants placed in healed sites. It was hypothesized that immediate loading is not inferior to conventional loading. Materials and Methods: A total of 62 patients with a missing maxillary anterior tooth were included. At random, patients were treated with an implant that was restored either with a nonoccluding temporary crown within 24 hours after implant placement (immediate group) or according to a two-stage procedure after 3 months (conventional group). All implants were placed in healed sites. Follow-up visits were performed after definitive crown delivery and 1 and 5 years thereafter. Outcome measures were radiographic marginal bone level changes, implant survival, complications, soft tissue aspects (probing depth, plaque, bleeding, soft tissue level changes), esthetic outcome, and patient satisfaction. Results: Three patients in each study group were lost to follow-up. No significant differences were found in terms of marginal bone loss (1.16 +/- 0.93 mm in the immediate group and 1.20 +/- 1.10 mm in the conventional group), survival (one implant lost in the immediate group), complications, soft tissue aspects, esthetic outcome, and patient satisfaction. Conclusion: For anterior single-tooth implants placed in healed sites, the outcome of immediate loading is not inferior to conventional loading.