Proper case selection is needed for a successful implant therapy. For a successful implant case, an appropriate healing response is required. Not all edentulous patients are candidates for implant therapy. Absolute medical contraindications exist and must be adhered to. In order to avoid any infection, implant failure, or even patient death. But then there are conditions, if stabilized, they do not interfere with healing; those are relative contraindications to elective oral surgery. The careful practitioner understands the nature of a number of diseases assess evidence regarding implant therapy in such patients and picks his or her cases based on this knowledge. It is an informed choice that we make, and if we choose properly, predictability results.