Implants with a small diameter may be used where bone width is reduced or in single-tooth gaps with limited mesiodistal space, such as for the replacement of lateral maxillary or mandibular incisors. The purpose of the present longitudinal study was to compare the prognosis of narrow implants (3.3-mm-diameter) to standard (4.1-mm-diameter) implants. Over a 7-year period, 122 narrow implants were inserted in 68 patients to support 45 partial fixed prostheses (PFD) and 23 single-tooth prostheses (ST). Furthermore, 120 patients received 208 standard implants and were restored with 70 PFD and 50 ST, respectively. Clinical and radiographic assessment data were provided. Six (1.8%) out of 330 implants failed. Cumulative survival and success rates were calculated with life-table analyses processed by collecting clinical and radiographic data. For narrow implants, the cumulative survival rate was 98.1% in the maxilla and 96.9% in the mandible. The cumulative success rate was 96.1% in the maxilla and 92% in the mandible. Conversely, standard-diameter implants showed a cumulative survival rate of 96.8% in the maxilla and 97.9% in the mandible. The cumulative success rate was 97.6% in the maxilla and 93.8% in the mandible. Cumulative survival and success rates of small-diameter implants and standard-diameter implants were not statistically different (P > 0.05). Type 4 bone was a determining failure factor, while marginal bone loss was not influenced by the different implant diameters. The results suggest that small-diameter implants can be successfully used in the treatment of partially edentulous patients.