Basal bone is that which is not absorbed in the course of a lifetime, because it is structurally necessary. The alveolar bone comes and goes with the teeth, but the basal bone remains stable, with its cortices. These are potentially strong anchors. This cortical anchorage is the key of this BOI philosophy. In BOI system, the fate of the alveolar ridge is not linked to the fate of the implant restoration complex Such Basal implants have a better prognosis because they leave the blood supply of the bone intact, and become a skeletized enossal implant fixture. This paper is a systematic review of the Basal osseointegrated system, its advantages, and considerations and applications with case reports. A Medline indexed search was conducted along with a manual search for articles on basal osseointegrated implants and the articles were selected.