Objectives: The ambition of this research is to gauge marginal bone loss (MBL) and peri-implant tissue health by comparing immediate and delayed implant implantation in a tertiary care setting. Methods: Subjects who had immediate and delayed implants were assessed. Clinical indicators such as bleeding on probing (BOP), peri-implant probing depth, and MBL were assessed at baseline and six months postimplantation. A result was considered statistically significant if it was P < 0.05. Findings: At first, there was no discernible variance between the demographic traits of the two groups. Regarding MBL and peri-implant probing depth, there were statistically significant (P < 0.05) deviations between groups at the six-month mark following implant installation. There were no appreciable variations in bleeding between the two groups, according to probing. Conclusion: In summary, compared to delayed implant placement, rapid implant placement was associated with MBL and increased peri-implant probing depth throughout a six-month follow-up period. These results emphasize the need for careful patient selection and treatment planning in implant dentistry. © 2024 Elsevier B.V., All rights reserved.