BACKGROUND Evidence is limited on the efficacy of zirconia-based fixed dental prostheses. OBJECTIVE The purpose of this systemic review was to assess zirconia-based FDPs in terms of survival and complications. METHODS Searches performed in PubMed databases were enriched by hand searches to identify suitable publications. The keywords used were: "zirconia" and "fixed dental prosthesis," "zirconia" and "crown," "zirconia" and "fixed partial denture" and "humans," "zirconia" and "crown" and "humans," "crown" and "all-ceramics," and "fixed partial denture" and "all-ceramics". Titles and abstracts were read to identify literature that fulfilled the inclusion criteria. Only peer reviewed clinical studies published in the English language from January 1999 through June 2011 were included. RESULTS Twelve clinical studies based on zirconia, framework design, and porcelain veneering technique met the inclusion criteria. Of the studies identified, 1 was a randomized clinical study with 3-year follow-up results; the others were cohort prospective studies. Clinical complications included chipping of veneering porcelain, abutment failure, and framework fracture. One study investigated pressed ceramics as the veneering material and found no chipping of veneering porcelain after 3 years. CONCLUSIONS Short term clinical data suggest that zirconia-based fixed dental prostheses may serve as an alternative to metal ceramic fixed dental prostheses in the anterior and posterior dentition.