Objective: To assess radiographic, clinical and patient-reported outcomes of single zirconia implant-supported crowns on titanium base abutments (TBA) over a 7.5-year period. Methods: Twenty-four patients received bone-level titanium implants and screw-retained zirconia implant crowns utilising TBA. Marginal bone level (MBL), clinical parameters (probing depth-PD, bleeding on probing-BoP, plaque control record-PCR), technical complications (USPHS criteria) and patient satisfaction were assessed at crown delivery (baseline), 1 year (FU-1) and at 7.5 years (FU-7.5) of follow-up. Results: Eighteen patients were available for re-examination at 7.5 years. The mean MBL at FU-7.5 (0.35 f 0.20mm) did not significantly change compared to baseline (0.54 f 0.39, p=.352) and to FU-1 (0.54 f 0.45mm, p=0.524). From baseline to 7.5 years, the mean PD increased significantly, from 3.0 f 0.6mm to 3.7 f 0.8mm (p=0.005). However, BoP and PCR did not significantly change; (BOP: from 27.1 f 20.7% to 25.0 f 20.0%, p=0.498; PCR: from 11.1 f 21.2% to 25.0 f 25.1%, p=0.100). Nine patients presented with more than one bleeding site. This denoted a peri-implant mucositis prevalence of 50%, whilst none of the implants presented peri-implantitis. One incidence of minor and major ceramic chipping were reported on 2 out of the 18 crowns, resulting in a prosthetic survival rate of 94.4%. Seventeen patients were highly satisfied with their result. Conclusion: Single implant-supported zirconia crowns on TBA displayed: (i) minor number of technical complications, (ii) high prosthetic survival rate, (iii) stable marginal bone level and (iv) high patient satisfaction at 7.5 years. Clinical implications: Titanium base abutments despite their high use in clinical practice, lacked medium- and long-term studies. The presented findings highlight their clinical performance at 7.5 years as they display satisfying radiographic, clinical and patient-related outcomes. TBA appear to be a suitable abutment choice for medium-term implant-supported restorations.