Dirofilaria immitis and Dirofilaria repens are mosquito-borne pathogens responsible for dirofilariasis in humans and animals. Their transmission and spread depend on the activity of vectors and the frequency of hosts in a given area. Here, we investigated the efficacy of a monthly multimodal prophylactic (MMP) strategy against canine dirofilariasis on Corsica Island (France). The study was conducted as evidence of an efficacy trial in which eighty dogs were divided into two groups: (i) one test group consisted of 25 dogs under the MMP (per-os administration of 1.5 tablets of milbemycin-oxime-praziquantel (Milbactor®) and a topical line-on application of a 3.6 mL solution of dinotefuran-permethrin-pyriproxyfen (Vectra® 3D)) and (ii) a control group under different real-life prophylactic treatments (RLP) based on the use of ectoparasiticides (different formulations: deltamethrin, fluralaner, fipronil) and/or macrocyclic lactone-based products (milbemycin-oxime/praziquantel, milbemycin-oxime, moxidectin) during the period from June to October 2017. All animals were followed up for one year, with blood collected at day 0, with follow-up at 6 and 12 months. Samples were tested for Dirofilaria spp. by species-specific qPCR. At the end of the study, no new case of Dirofilaria spp. infection was detected in the test group. However, the cumulative incidence of Dirofilaria spp. infection was 16.4% (n = 9; p = 0.027) in the control group. The data illustrate that, in contrast to RLP treatment, which failed to protect at least 16.4% of dogs, the MMP based on the simultaneous administration of milbemycin oxime-praziquantel and dinotefuran-permethrin-pyriproxyfen efficiently protects dogs in a high-risk area from Dirofilaria spp. infection.