This pilot case series histologically and histometrically investigated the influence of implant surface hydrophilicity on early osseointegration and peri-implant bone formation around simultaneously grafted immediate implants. Core biopsies of the hydrophilic test (SLAactive®) or hydrophobic control (SLA®) implants immediately placed in maxillary molar extraction sites and simultaneously grafted with mineralized cancellous bone allograft (MCBA) obtained at 3 weeks post-placement were histometrically compared for bone to implant contact, the quantity of graft material, new bone formation, tissue reaction, and inflammatory scores. Test implants showed a more pronounced implant-bone apposition, peri-implant bone formation and bone aggregate than control implants. Trabecular bone formation and maturation were also qualitatively advanced around test implants. These results indicate that the implant surface bone graft combination may affect peri-implant bone formation.