The placement of Dental Implants in the anterior maxilla presents unique challenges due to being the region of the mouth that is visible when people smile. In placing dental implants in the esthetic zone, the goal is dental implant restorations that are in harmony with adjacent teeth, have a natural appearance as well as being esthetically pleasing for the patient. To accomplish this, strict adherence to principles involving bone and soft tissue is important to ensure that optimal contours of tissue are present around dental implants. Knowledge of dentition-related factors such as the location of the smile line, the type of tissue biotype, and the location of biologic width are important factors that contribute to having esthetic success of implants in the anterior maxilla as well as the use of a Restoration driven placement protocol. During this course, one of the major goals is to review how to perform a risk assessment. Completing an esthetic risk assessment helps with identifying and mitigating potential risk factors that could prevent dental success as well as allowing for setting realistic expectations with patients about what outcome to expect with their dental implant therapy. We will also review esthetic, anatomic, and iatrogenic factors that contribute to affecting implant survival and overall esthetic success and ways of mitigating those factors to ensure esthetic success in the anterior maxilla.