Background: Limited information is available on the influence of timing of implant placement after tooth extraction on the marginal peri-implant conditions in the long-term. Aim/Hypothesis: To report on the marginal peri-implant soft and hard tissue levels, including prevalence of peri-implant mucositis and peri-implantitis, 10 years after early (Ea), delayed (De), or late (La) implant placement. Material and methods: 64 patients, previously randomly allocated, received a single-tooth implant (Osseotite, 3i Biomet) on average 10 days (Ea: 23), 3 months (De: 22), or 12 months (La: 19) after tooth extraction. Second stage surgery was performed after 3–4 months and porcelain-fused-to-metal crowns were cemented on the implants after one additional month (TC). All patients were recalled for a clinical and radiographic examination approximately one (T1) and 10 years (T10) after implant installation. Marginal peri-implant bone levels (BL) were measured on orthogonal periapical radiographs at TC, T1, and T10. Differences among the implant placement protocols were tested by Anova and chi-square tests. Results: At T10, clinical and radiographic data were available from 49 and 48 patients, respectively; 47 patients attended all controls, while radiographic data from all visits were available for 39 patients. Proximal BL for all implants was located at 1.39 0.65 mm, 1.32 0.63 mm, and 1.38 0.98 mm apically to the implant shoulder, at TC, T1, and T10, respectively. No significant differences in proximal BL were found among the groups at TC and T10. At T1, BL was located more apically at De implants (1.71 mm) compared to Ea and La implants (1.09 and 0.99 mm, respectively) (P = 0.002). No significant differences in BL were found between TC and T10 or between T1 and T10 both regarding all implants and within each group. 55% and 47% of the implants showed at least one site with a probing depth (PD) ≥5 mm at TC and T1, respectively. At T10, 70% of the implants showed bleeding or pus on probing (BoP) and 36% of the implants showed one or more sites with PD ≥5 mm; no significant differences among the groups were seen. At T10, only two implants (De and La) (4.3%) suffered from peri-implantitis defined as PD ≥5 mm, BoP, and marginal bone loss of >1 mm from TC. Conclusions and clinical implications: Timing of implant placement after tooth extraction did not significantly influence the marginal peri-implant soft and hard tissue levels in the longterm. Peri-implant mucositis was a frequent finding, while peri-implantitis was only scarce. This study was partially supported by 3i Biomet, FL, USA.