Alveolar bone crest undergoes dimensional ridge changes after tooth extraction, these changes cannot be completely counteracted, even though proper management could allow the achievement of the best possible outcome for the patient. The ridge preservation technique is known to be effective in the reduction of alveolar bone resorption after tooth extraction. The objective of this lecture was to illustrate the surgical techniques and the biological principles that should be followed to obtain better clinical outcomes. The fresh extraction socket classification will be discussed. The flapless and flapped techniques to perform socket preservation is still considered a matter of discussion in the scientific community. The advantage and disadvantages of each approach will be illustrated. The flapless ridge preservation technique showed to be as effective as the flapped technique since the bone healing was similar within the two groups. The flapless surgical protocol seems to offer several clinical advantages such as less postoperative discomfort and swelling, better preservation of keratinized gingiva, and stability of mucogingival junction. The indications and the clinical parameters that should be evaluated before placing an implant into a fresh extraction socket will be discussed.