The 10 keys for successful esthetic-zone single immediate implants encapsulate in an evidencebased manner the treatment planning and replacement of single hopeless teeth in the maxillary anterior sextant. These include 2 treatment-planning, 5 surgical, and 3 prosthetic keys, which, collectively, aim to minimize soft- and hard-tissue complications for an optimal esthetic implant restoration. The straightforward, advanced, and complex (SAC) classification was designed to aid clinicians in the treatment planning of dental implant cases. Cases are stratified by the degree of surgical and restorative risk and complexity for both the surgical and prosthetic phases of treatment. Based on the 10 keys, the management of an immediate implant in the esthetic zone is considered a complex SAC procedure. As described in this article, a complex SAC procedure requires careful patient selection and treatment planning, along with precise execution by skillful clinicians, to achieve successful results.