Aim: To compare the stability and survival rate of the immediate dental implants that are placed in the fresh extraction sockets with and without bone grafts. Methods: An electronic search in MEDLINE (PubMed) and the Cochrane Library were performed to include randomized controlled trials on immediate implants with a mean follow-up time of at least 6 months. We hand searched citation lists of relevant publications. No language or date restriction was applied. Independently the authors screened, reviewed and assessed the studies for the risk of bias. This was followed by data extraction and analysis of different outcomes. Results: We included two studies (68 participants). The two studies reported no implant failures after 6 months follow up period, so no difference in the implant survival between the two groups (RR 1.00, 95% CI, 0.92 to 1.08). One trial reported the bone density after 6 months follow up. There is significant difference in bone density favor the use of bone grafting materials group (RR 245.00, 95% CI, 38.51 to 451.49) and one trial reported the bucco-lingual crestal width with significant difference in favor the use of bone grafting materials group (1.31, 95% CI, 0.38 to 2.23). No trial evaluated the implant survival rate, bone density and bucco-lingual crestal width after one year. Implant stability, patient satisfaction and the post-surgical marginal bone loss were not reported on the included trials. Conclusions: There is inadequate evidence to suggest the bone grafts with immediate post-extraction single tooth implants to enhance implant stability and survival rate.