Background There is limited data available on the survival of monolithic zirconia single crowns with titanium resin based abutments. Aim/Hypothesis The aim of this follow-up case series was to evaluate the prosthetic maintenance of screw retained posterior monolithic zirconia crowns after 1 to 3 years of clinical service. Material and Methods Nineteen patients who had received a single implant in the posterior region were included. Titanium resin based abutments were used to fabricate monolithic zirconia crowns. After try in, crowns were cemented onto the abutments with resin cements in the laboratory. Peri-implant parameters, mechanical and biologic complications and patient satisfaction parameters were recorded at baseline and all follow-up examinations. Results A total of 35 monolithic zirconia crowns (22 molar and 13 premolar) were examined. None of the patients had neither screw-loosening nor decementation. Parallel periapical examination revealed a marginal bone loss less than 0.5 mm. Peri-implant parameters gingival index, plaque index, and gingival bleeding time index scores were generally lower in all crowns indicating peri-implant health situation. Conclusions and Clinical Implications Screw retained monolithic zirconia crowns based on titanium based resin abutments were promising treatment option on single implant restorations.