The placement of an implant immediately after tooth extraction offers the advantages of treatment time reduction and potentially increased patient satisfaction and treatment acceptance. Preservation of the labio-palatal ridge dimension is the prime goal following immediate implant placement in the anterior maxilla. Nevertheless, it is well established that hard and soft tissue volume are substantially altered at extraction sites particularly in the esthetic zone especially in thin buccal bone. Hence, achieving long-term soft and hard tissue stability with immediate implant has been considered a challenge in everyday clinical practice. In most clinical situations encountered, augmentation procedures are needed to achieve adequate bony contours around the implant. Several techniques have been proposed to preserve the buccal plate from bone resorption following immediate implant placement with no proven effectiveness. Several surgical techniques have been proposed over the years to preserve the soft and hard tissues in the esthetic zone, commencing with proper 3D implant positioning, flapless approach, following the addition of bone graft, the application of a connective tissue graft, the socket shield technique, or the use of customized healing abutment. Furthermore, the innovation of new techniques such as vestibular socket therapy, dual-zone concept, bone shielding concepts and immediate dentoalveolar restoration were introduced to counteract the peri-implant tissue reduction.