The metal-acrylic implant supported fixed dental prosthesis (MAISFDP) is the most commonly reported fixed implant prosthesis used to treat edentulism. Although favorable long-term implant and prosthetic survival rates have been demonstrated, complications involving the material such as veneer fracture can occur at a high rate. The monolithic zirconia implant supported fixed dental prosthesis (MZISFDP) is proposed to offer similar favorable outcomes as MAISFDP with fewer complications. This retrospective study shows that over a mean follow-up period of 41 months, MZISFDPs demonstrate high implant and prosthetic survival rates (100%) with highly favorable patient reported outcomes. Technical complications such as veneering fracture are lower (14%) but a unique set of complications such as debonded MZISFDP titanium abutments can occur. The biological complications reported in the study are similar to those reported in other MAISFDP studies. This study shows that MZISFDPs are a viable treatment option for edentulism.