BACKGROUND Immediate implant-loading protocol has progressed because of various clinical advantages offered by this treatment approach. However, available studies on edentulous patients are still few compared to those in which delayed implant-loading protocol was applied. OBJECTIVE This prospective study was to evaluate the implant survival rate and the peri-implant tissue response in a group of patients who received two unsplinted immediately loaded dental implants in the mandibular anterior region to retain a complete overdenture using locator attachments. METHODS A total of 24 edentulous patients with a mean age of 63.4 years were involved in this study following certain inclusion criteria. All patients received a new set of complete dentures before implant positioning. Two Prima Connex tapered implants were put in the interforaminal area of the mandible with a flapless surgical procedure, and the prefabricated dentures were immediately retained with a zest locator attachment. Clinical and radiographic records of the patients were reviewed immediately after placement of the implant, at 3 months, and at 1, 2, and 3 years following fixture installation. The obtained data were analyzed using paired samples t-test and the Wilcoxon signed-rank test at 0.05 significance level. RESULTS At 3 years, all implants had osseointegrated with a 100% survival rate. In addition, the total mean marginal bone change was -0.89 ± 0.14 mm, and the mean periotest value was -7.631 ± 0.921. CONCLUSIONS Results of this study propose that immediate loading of mandibular implant overdentures that are retained with locator attachments was a feasible treatment alternative for this particular group of patients. CONCLUSIONS Immediate implant- loading of mandibular implant overdentures that are retained with locator attachments is a reliable treatment option Keywords: Immediate implant loading, Implant survival rate, Locator attachments, Overdenture.