The management of the failing maxillary central incisor remains one of the most demanding challenges in implant dentistry, where hard and soft tissue deficiencies can significantly influence aesthetic and functional outcomes. Successful treatment requires careful diagnosis, risk assessment, and strategic decision-making to optimise tissue stability in the aesthetic zone. This presentation will showcase a practical, clinically focused approach to managing the failing central incisor, highlighting key hard and soft tissue considerations that influence treatment planning and surgical outcomes. Topics will include timing of extraction and implant placement, ridge preservation, management of alveolar defects, soft tissue augmentation, and restorative considerations to optimise peri-implant aesthetics. Clinical cases will be used to illustrate treatment strategies and management of common challenges in compromised anterior sites.