Background <p>To investigate the clinical efficacy of the simple taper retention implant with external connection JUST J1 MINI (J1 implant) in narrow anterior alveolar ridges (4.5–5.5&#xa0;mm) for a follow-up period of 5–7 years.</p> Methods <p>This is a prospective cohort study, which included a total of 96 J1 implants in the narrow anterior alveolar ridges without bone augmentation. Patients were followed up for 5–7 years post-superstructure restoration, with analysis of peri-implant tissues’ health and comparison of bone level changes.</p> Results <p>During the 5-7-year follow-up period, four implants failed, resulting in a final survival rate of 95.8%. Bone levels were measured at three-time points: implant placement (T0), final restoration (T1), and final follow-up (T2). The lingual bone level at the implant apex (L0) showed statistically significant differences among T0, T1, and T2 (<i>P</i> &lt; 0.05). None of the measured sites in the maxillary implants exhibited statistically significant differences (<i>P</i> &gt; 0.05), whereas the L0 site in the mandible showed statistically significant differences (<i>P</i> &lt; 0.05). Regarding immediate and delayed implantation, no statistically significant differences were observed (<i>P</i> &gt; 0.05). At the end of the follow-up, peri-implant soft tissues remained healthy, without showing any signs of mechanical failures or biological complications.</p> Conclusion <p>The simple taper retention implant with external connection J1 in the narrow anterior alveolar ridges can achieve functional and aesthetic outcomes, ensuring long-term stability of the peri-implant soft and hard tissues without bone augmentation.</p>