Objective: The aim of the current study is to evaluate accuracy of computer and image guided implant placement using 3D printed Surgical Guiding Template for the all on four treatment option configuration concept.Patients and methods: six patients with completely edentulous mandibles were scanned with Cone-beam computed tomography (CBCT). Data was used for virtual placement, and production of surgical guiding template (SGT) with rapid prototyping for transfer of virtual plan to surgical field. Each patient received four implants each, making a total of 24 implants. Immediate post-operative CBCT was taken for all patients and the acquired image data set of each patient was merged with the pre-operative set to evaluate amount of error/deviation between virtual and post-operative implants.Results: The overall amount of error deviation showed a median of 2.05 mm in linear measurements. Axial error deviation showed a median of 3.79°. Height discrepancies from linear measurements showed a median and range of 0.99 mm and 0.33 – 2.99 mm. Anterior-posterior displacement showed a Median (Range) of 0.81 mm (0.27 – 1.17 mm). The median of linear values of error deviation in the anterior implants measured in mm was 2.05 mm and those of the posterior implants was 1.69 mm which is statistically significant with a P–value = 0.05. The same was interpreted from observing the 3D changes of error deviation with a P-value 0.019 when comparing anterior and posterior 3D measurements. Height difference showed no statistical significant difference when comparing anterior and posterior data, having a median of 1.25 mm and 0.78 mm respectively with a P-value = 0.316.Conclusion: Computer guided implant placement using this treatment protocol proved to be accurate, with significant improvement in accuracy values of linear and angular measurements and revealing significant accuracy in the posterior implants more than the anterior ones, even though the results are promising they are error values nonetheless a safety margin should be considered when attempting computer guided implant treatment planning. Relevantly the causes of these errors are identifiable and prone for quantification, improvements and further investigation.