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Aim: The rate of early dental implant failure (DIF) has increased in recent years, though the risk factors associated with this primary failure remain unclear. This study aimed to determine the rate of early implant failure and identify contributing factors. It was conducted from March 2018 to 2020 in Mashhad, Iran., Method: This observational study examined the records of 983 implants from the Implant Department of Mashhad Dental School. Variables considered included age, gender, systemic diseases, smoking habits, implant type and size, and surgery-related factors. Data were analyzed using Chi-square, Mann-Whitney U , and Fisher exact tests in SPSS V22, with a p -value of 0.05 or less considered statistically significant., Result: Of the 983 implants, 42 (4.3%) experienced early failure. The study population consisted of 555 (56.5%) females and 428 (43.5%) males, with an average age of 49.34 ± 13.67 years. A significant correlation was found between surgical complications (e.g., fracture of implant fixtures and inferior alveolar nerve exposure) and implant loading time (Yes or No) with early DIF ( p =0.05 and p < 0.01, respectively). However, no significant correlation was observed between early failure and factors such as age, gender, smoking habits, systemic diseases, implant dimensions, or manufacturer., Conclusion: Surgical complications and loading time may be the most critical factors contributing to early implant failure. Therefore, we suggest dentists pay attention to the mentioned factors in the surgical protocols and their relationship. Further prospective studies on risk factors that could affect early implant failure are needed., Competing Interests: The authors have no conflicts of interest to declare., (Copyright © 2023 Majid Hosseini Abrishami et al.)