The predictability of successful osseointegrated implant rehabilitation of the edentulous jaw as described by Branemark et al., introduced a new era of management for the edentulous predicament. Implant rehabilitation of the edentulous maxilla remains one of the most complex restorative challenges because of the number of variables that affect both the aesthetic and functional aspect of the prosthesis. Among the prosthesis designs used to treat the edentulous maxilla are fixed or removable implant-supported restorations. Since the aesthetic requirements and preoperative situation of each patient varies, considerable time must be spent on accurate diagnosis to ensure patient desires are satisfied and predictable outcomes are achieved. The purpose of this article is to compare the treatment options and prosthesis designs for the edentulous maxilla. Emphasis will be placed on diagnosis and treatment planning. Criteria will be given to guide the practitioner in deciding whether a fixed or removable restoration should be placed. This objective will be accomplished through the review of cases with regard to varying design considerations and factors that influence the decision-making process.