Objective: To evaluate the impact of the timing of restoration on clinical and aesthetic outcomes following immediate implant placement in the maxillary aesthetic zone. Material and Methods: Forty patients (16 males, 24 females) with a mean age of 50.55 ± 12.79 years (range 19–74) who had a single maxillary anterior tooth replaced by an immediate implant were included in this study. Twenty patients had their implant restored immediately with a provisional restoration (Group A), while the other 20 patients had a delayed restoration placed after 3–4 months of non-submerged healing (Group B). Clinical parameters and hard-tissue changes were evaluated after a mean follow-up period of 3 years. Aesthetic evaluation was carried out using the Pink Esthetic Score (PES) and the White Esthetic Score (WES). Results: No significant differences were observed in the bone level changes between the two groups: 0.05 ± 0.65 mm mesially and 0.06 ± 0.52 mm distally for the immediate group and 0.30 ± 0.54 mm mesially and 0.21 ± 0.60 mm distally for the delayed group, respectively. The median PES scores were 11.5 for Group A and 10 for Group B. Mean PES and WES scores did not differ significantly between Groups A and B: PES (11.1 vs. 10.3; p = .16) and WES (8.4 vs. 7.8; p = .16). In terms of individual PES variables, the distal papillae were significantly better in Group A as compared to Group B (p = .006). Conclusions: Within the limits of this study, timing of restoration seemed to positively affect the aesthetic outcomes of immediately placed implants as evidenced by higher median PES values for the immediate restoration group when compared to the delayed restoration group. Restoration timing had no impact on the individual PES variables, except for the distal papillary height which was superior in the immediate restoration group.