This lecture provides a comprehensive clinical guide to immediate implant placement in posterior regions, addressing the unique anatomical challenges of molar and premolar extraction sites. Starting with patient selection and indications, the presentation systematically covers the Smith & Tarnow classification of molar extraction sockets (Type A, B, and C) and the corresponding surgical strategies for each scenario—including septal bone engagement, gap management with or without bone grafting, and sinus floor elevation via osteodensification. Through detailed clinical case demonstrations, attendees will learn how to achieve predictable primary stability, manage primary wound closure, and optimize long-term restorative outcomes in posterior immediate implant cases.