Dental implants have risen as the gold standard for oral rehabilitation, offering predictable outcomes and improved quality of life for patients with missing teeth. However, postmenopausal women constitute a distinct patient population due to the systemic effects of estrogen deficiency, particularly on bone metabolism. The decline in estrogen levels following menopause can negatively impact bone remodeling, potentially influencing osseointegration and the long-term success of dental implants. This review aims to evaluate the current evidence regarding implant outcomes in postmenopausal women, examine the biological implications of hormonal changes on bone physiology, quality, and quantity, and provide evidence-based clinical recommendations to enhance treatment planning and optimize outcomes in this demographic segment.