Dental implant rehabilitation in patients with head and neck cancer who have undergone radiotherapy presents unique challenges. Ionizing radiation induces hypocellular, hypovascular, and hypoxic bone conditions that compromise osseointegration. However, contemporary evidence demonstrates that dental implants can achieve favorable survival rates in irradiated bones when appropriate protocols are followed. The critical factors influencing success include radiation dose, timing of implant placement, anatomical site selection, and meticulous surgical technique. This review synthesizes the current evidence to guide clinicians in optimizing implant outcomes in this challenging patient population.