Objective To explore the application of digital surgical guide in immediate implantation of maxillary anterior teeth and its influence on implant placement accuracy and aesthetic effect. Methods A total of 80 patients (80 affected teeth) receiving immediate implantation of maxillary anterior teeth at Baicheng Xingdong Dental Clinic from January 2023 to December 2025 were selected as the research subjects. According to the random number table method, they were divided into group A and group B, with 40 patients (40 affected teeth) in each group. Group A adopted conventional immediate implantation technique, and group B adopted digital surgical guide technique. The implant placement accuracy, aesthetic effect, implant stability quotient (ISQ) and marginal bone loss (MBL) were compared between the two groups. Results The neck distance deviation, apical distance deviation, depth deviation and angle deviation in group B immediately after operation were less than those in group A (P <0.05). At 6 months after operation, the scores of PES and WES in group B were higher than those in group A (P <0.05). The immediate postoperative ISQ value in group B was higher than that in group A (P <0.05). At 6 months after operation, the MBL of group B was less than that of group A (P <0.05). Conclusion For immediate implantation of maxillary anterior teeth, the application of digital surgical guide can improve three-dimensional implant placement accuracy, optimize aesthetic effect, enhance primary implant stability, and reduce postoperative MBL.