A fairly common treatment modality for anterior and posterior single-rooted teeth, immediate implant placement in molar areas is less prevalent. Technical challenges can arise when creating an implant osteotomy in a fresh extraction socket of a multi-rooted tooth. Also, the proximity to important anatomic structures and the difficulty in achieving adequate implant stability in wide sockets can also be hindrances. The principles of osseodensification may be utilized as part of a novel, predictable technique for immediate molar replacement with an implant. This article discusses the osseodensification technique, including such key factors as site assessment, radiographic evaluation, minimally traumatic tooth removal, implant positioning, and instrumentation.