To assess the survival and complication rates of tooth-implant supported fixed dental prostheses (T-I FDPs). An electronic search in MEDLINE/PubMed, Cochrane Library, and Embase was conducted using MeSH terms to identify randomised controlled trials (RCTs) or prospective studies with an observation period of at least 3 years, including at least 10 participants. Included studies were qualitatively assessed. Survival rates of T-I FDPs and implants as well as technical and biological complications were obtained. Failure and complication rates were pooled by weighting each rate in inverse proportion to its variance. A total of eight studies were considered for qualitative analysis; seven studies with a minimum follow-up of five years were included for quantitative analysis. Estimated survival rates of T-I FDPs were 90.8% (95% CI: 86.4-93.8%) after five years and 82.5% (95% CI: 74.7-88.0%) after 10 years. Implant survival estimates were 94.8% (90.9-97.0%) and 89.8% (82.7-99.4%) after 5 and 10 years, respectively. From a total of 185 T-I FDPs, 21 (11.4%) minor and 23 (12.4%) major biological complications were observed, whereas 23 (12.4%) minor and three (1.6%) major technical complications occurred. Due to the lack of well-designed studies exceeding a 10-year follow-up, prognosis for the long -term can hardly be given. Considering the inclusion criteria of this systematic review, T-I FDP-supported fixed dental prostheses show acceptable survival rates after five and 10 years. Rigidly constructed T-I FDPs should be preferred. With regard to the available data, these conclusions are valid only for three- to four-unit T-I FDPs. Tooth-implant supported fixed dental prostheses are a recommendable treatment option in partial dentition. Based on the current literature, they should be rigidly constructed with a maximum number of four units.