ABSTRACT Background: Immediate implants have been commonly used for the single or bi-rooted teeth. However, it was a challenge and an intriguing dilemma with respect to molar teeth, due tothe presence of multiple factors such as: multiple root morphology,achieving implant stability and bone to implant contact.The aim of this study was to assess the efficiency of using A-PRFautograft mixture around implants placed immediately in mandibular molar region from aclinical and radiographic point of view. Patient and methods: This study was carried out as a randomized controlled clinical trial in which twenty patients needing extraction of unrestored mandibular molars and placing of immediate implant, were selected. Patients were divided into two groups randomly; the study group where the resultant gap following the immediate insertion of a molar implant was filled with A-PRFautograft mixtureand the control group where peri-implant gap was filled with autogenous bone graft alone.The studied variables were the degree of facial swelling, marginal bone height and the bone density around the immediately installed dental implants. The period for follow up was after six months. For statistical analysis,Mann- Whitney U test was used. Results: The study group showed better results in the clinical and radiographic studied variables. A significant difference was seen regarding the marginal bone height.Although, regarding bone density and swelling, more acceptable results have been seen within the study group, the results showed no statistically significant difference between both groups. Conclusion:The results assured the efficiency of using A-PRF-autograft mixturewith concurrent placement of immediate implants in the lower molar region and highlighted their promising effects on bone and soft tissue healing. Key Words:Immediate implant, mandibular molar, Advanced Platelet rich fibrin, autogenous bone.