To compare the accuracy and primary stability of tapered and straight implants undergoing immediate implant placement with dynamic navigation. Patients with compromised anterior teeth in maxilla were recruited and allocated randomly into (1) tapered implant group (TI group) and (2) straight implant group (SI group). Implants were inserted into fresh sockets with dynamic navigation. Three-dimensional platform deviation, apex deviation, angular deviation, insertion torque value (ITV) and implant stability quotient (ISQ) were recorded. Twenty patients with 20 implants were included. The overall platform, apex, and angular deviation were 0.87 ± 0.35mm, 0.81 ± 0.34mm, and 2.40 ± 1.31°, respectively. The accuracy was 0.86 ± 0.26mm, 0.76 ± 0.33mm, and 2.49 ± 1.54° for TI, and 0.89 ± 0.44mm, 0.88 ± 0.36mm, and 2.31 ± 1.01° for SI, with no significant difference (p = 0.85, 0.45, 0.76). Sagittal root position classification (SRP) class I may obtain greater error in numerical values in straight implants (0.97 ± 0.47mm vs. 0.6 ± 0.16mm, 0.92 ± 0.36mm vs. 0.73 ± 0.36mm, 2.48 ± 1.19° vs. 1.71 ± 0.14°). The overall ISQ was 60.74. ISQ was 60.48 for TI and 60.96 for SI, with no significant difference. Acceptable ITV (> 15Ncm) was achieved in most of the included patients (SI 7/10, TI 9/10). High accuracy and primary stability of immediate implant placement could be achieved both in tapered and straight implants with dynamic navigation systems. Tapered and straight implants did not reach a consensus on which was better in immediate implant regarding to accuracy and primary stability. Our study demonstrated implant macrodesign did not affect accuracy and primary stability in immediate implant using dynamic navigation.