Purpose: To investigate the risk factors related to failure of removable partial dentures (RPDs) and to compare the survival of RPDs when abutment teeth have good vs reduced bone support. Materials and Methods: In this longitudinal patient record-based cohort study with a mean follow-up of 44.9 months, Cox regression models were used to evaluate the associations between clinical covariates and abutment tooth failure, as well as prosthesis failure. Results: A total of 142 patients and 172 RPDs were included. Of the 172 prostheses, 64 (nearly 40%) failed after a mean time of about 4 years. Loss of abutment teeth was the main reason leading to RPD failure, followed closely by poor fit and adaptation. No factor was shown to be statistically significant at the prosthesis level. Women (Hazard Ratio [HR] = 0.542), endodontic treatment (HR = 3.460), presence of post and core (HR = 0.302), presence of a prosthetic crown (HR = 3.403), and abutment tooth type (in relation to incisor: canine HR = 0.196, premolar HR = 0.449) were the risk factors statistically significantly associated with the loss of abutment teeth. The pre-prosthesis amount of bone support of the teeth did not affect their prognosis as abutments for RPDs. Conclusion: RPD treatment modality presented a high failure rate after a mean follow-up of 4 years. Vital abutment teeth had a better survival rate than the ones treated endodontically (whether restored with or without a post and core); nevertheless, the amount of bone support did not affect their survival.