Zygomatic implants have become a predictable treatment modality for rehabilitation of the severely atrophic maxilla, eliminating the need for extensive bone grafting and sinus augmentation procedures. This systematic review evaluates survival rates and associated clinical outcomes of zygomatic implants reported in studies published between 2015 and 2025. A structured review of human clinical investigations with a minimum follow-up period of one year was undertaken. Data regarding implant survival, surgical approach, loading protocols, and biological or mechanical complications were analyzed qualitatively. The evidence consistently demonstrates high survival rates ranging between 94% and 99% over follow-up periods extending beyond five years. Engagement of dense zygomatic cortical bone contributes to excellent primary stability, supporting immediate loading in appropriately selected cases. Extrasinus and anatomy-guided approaches show reduced sinus morbidity compared to intrasinus techniques. Common complications include sinusitis, mucosal inflammation, soft-tissue recession, and prosthetic component issues; however, most are manageable with timely intervention. Digital planning, CBCT-based evaluation, and guided surgical systems have enhanced placement accuracy and minimized intraoperative risks. Although survival outcomes are favorable, heterogeneity in study designs and reporting standards limits direct comparison among investigations. Long-term monitoring remains essential due to potential sinus changes and prosthetic maintenance requirements. Overall, literature from the past decade confirms zygomatic implants as a durable and efficient solution for full-arch rehabilitation of the atrophic maxilla when performed by experienced clinicians using appropriate planning protocols.