OBJECTIVES: Computer-aided implant surgery (CAIS) is a fully digital approach that guides the biological and prosthetic ideal implant position. The aim of this retrospective clinical study was to assess the accuracy of implant position using CAIS and clinical outcomes, in partially edentulous patients. MATERIAL AND METHODS: This study was designed as retrospective study. Twenty-one patients requiring a maximum of two implants were recruited from 2023 to 2024 at the University of Naples Federico II. For all patients, 3D cone-beam computed tomography (CBCT) and intraoral scans were obtained and superimposed by matching the resulting DICOM and STL data files in a software to create the tooth-supported surgical guide. All implants were placed using a fully guided implant surgery protocol. The accuracy of the technique was measured by the deviation between the actual implant position (mesio-distal deviation, depth error, and axis deviation) obtained from the postoperative CBCT and the preoperative planned implant position. Clinical outcomes assessed included biological complications, implant and prosthetic failures, esthetic outcomes, and patient satisfaction. Descriptive analysis was performed using mean and standard deviation. RESULTS: A total of 37 implants were analyzed. The mean results were as follows: 0.43 ± 0.20 mm of mesio-distal linear deviation at the implant shoulder, 0.24 ± 0.07 mm of depth error, and 1.46° ± 0.31° of axis deviation. At 6 months, healing was uneventful for all patients, with no complications or implant or prosthetic failures reported. Patients with implant-supported restorations expressed high levels of functional and esthetic satisfaction. CONCLUSIONS: The fully guided technique achieved clinically acceptable accuracy positioning of dental implants in partially edentulous patients.