The introduction of osseointegrated implants in dentistry represents a turning point in dental clinical practice. Thanks to their multiple therapeutic possibilities and the high predictability of success, implant therapy is now regarded as an extremely reliable approach to replace missing teeth. The concept of immediate implant loading has recently become popular due to less trauma, reduced overall treatment time, decreased patient's anxiety and discomfort, high patient acceptance and better function and esthetics. Nonetheless, research and understanding in this area are confuse and sometimes contradictory. Hence, it is the purpose of this review to provide rational for immediate implant loading, summarize current available literature, and analyze factors that influencing this newly introduced treatment method. Results from this review indicated that immediate implant loading achieved similar high success rate as that noted in the conventional approach (delayed protocols). However, a careful case selection, proper treatment plan, meticulous surgery and proper design of prosthesis are essential for optimal outcomes when this approach is adopted.