The aim of this study was to examine the influence of smoking on osseointegrated implant failure by performing a meta-analysis. A computerized literature search using PubMed database (in English) and Japana Centra Revuo Medicina (in Japanese) was carried out to identify all relevant studies. Among 175 studies identified and chosen for detailed review, 19 were appropriate for inclusion in our meta-analysis. When smokers were compared with non-smokers, odds ratio (OR) for osseointegrated implant failure was significantly elevated (OR 2.17, 95% confidence intervals (CI), 1.67–2.83). Seven studies were appropriate to examine the influence of intra-oral location (maxillary arch vs. mandibular arch) of implant failure on smoking. The OR for implant failure occurring in the maxillary arch was significantly elevated (OR 2.06, 95% CI, 1.61–2.65), whereas the OR in the mandibular arch did not demonstrate a significant increased risk associated with smoking (OR 1.32, 95% CI, 0.72–2.4). Our meta-analysis revealed a significant relationship between smoking and the risk of osseointegrated implant failure, more particularly those implants located in the maxillary arch.