Patients with an edentulous maxilla can be treated with conventional removable prosthetics or implant therapy. Implant prosthetic options can be removable, in the form of overdenture therapy, or fixed. The surgical approaches, implant systems, and prosthetic designs vary significantly. Consequently, the choices for the restorative–surgical team are numerous. This article presents an overview of the maxillary edentulous conditions and how implant therapy impacts on the possible restorative solutions. Various fixed treatment approaches are discussed, as well as guidelines for prosthetic reconstruction.