Objective To evaluate the influence of surgery start time (SST) and other patient‐ and therapy‐related variables on the risk for early implant failure (EIF) in an academic setting. Material and Methods Data were extracted from the electronic health records of 61 patients who had at least one EIF and 140 age‐ and gender‐matched, randomly selected, non‐EIF controls. Bivariate and multivariable analyses were performed to identify relevant associations between EIF and different variables, such as SST. Results Incidence of EIF was not significantly associated with SST (HR: 1.9 for afternoon implant placement, 95% CI: 0.9–3.9; p = .105). Other factors that were associated with a significantly increased risk for EIF in a multivariable model were pre‐placement ridge augmentation (HR: 7.5, 95% CI: 2.2–25.1; p = .001), intra‐operative complications (HR: 5.9, 95% CI: 2.2–16.3; p < .001), simultaneous soft tissue grafting (HR: 5.03, 95% CI: 1.3–19.5; p = .020), simultaneous bone grafting (HR: 3.7, 95% CI: 1.6–8.8; p = .002), and placement with sedation (HR: 3.4, 95% CI: 1.5–7.5; p = .002). Conclusions While SST was not associated with the occurrence of EIF in our cohort, other variables, such as ridge augmentation prior to implant placement, simultaneous bone or soft tissue grafting, intra‐operative complications, implant placement with sedation, and number of implants in the oral cavity, were associated with an increased risk for this adverse event.