PURPOSE: Application of endosseous implants in prosthetic orbital reconstruction seems to be very successful, but few reports have evaluated cumulative survival rates of orbital implants over a long period. The aim of this study was to analyze long-term survival rates and potential influencing factors of orbital implants. MATERIALS AND METHODS: A retrospective evaluation of patients treated with extraoral screw implants for retaining orbital prostheses from 1991 to 2014 was performed. Patient records were assessed for implant survival, demographic data, defect etiology, irradiation status, location of implant placement, implant systems, length, and retention type. Data were analyzed using the Kaplan-Meier method and log-rank test to compare survival curves. RESULTS: A total of 282 orbital implants placed in 78 patients were evaluated during an observation period ranging from 2 to 268 months (mean: 94.97 months). The cumulative implant survival rate was 91.3% at 2 years, 80.5% at 5 years, 68.7% at 10 years, and 62.2% after 15 years. The survival rate was significantly higher in females (75.3%) vs males (47.3%), in supraorbital vs infraorbital implants (67.4% vs 51.5%), and in Brånemark implants (70.2%) vs Straumann implants (54.5%). CONCLUSION: The presented data suggest that the long-term predictability of orbital implants revealed good to acceptable results. Factors such as female gender, localization in the supraorbital rim, a machined surface of the implant system, length, and magnetic retention seem to affect the implant survival rate positively, whereas irradiation status does not show any influence. These factors should be considered in planning future patient rehabilitation.