Background: The successful implant placement requires ideal amount of bone in vertical and horizontal dimensions. The deficient bone limits placement of implants of ideal size, length in prosthetically driven position. This study was performed to assess the use of ridge split technique with simultaneous implant placement in the management of horizontally deficient alveolar ridges. Methods: The patients were selected with inadequate alveolar width of 3 to 4 millimeters and with adequate alveolar bone height. The cone beam computerized tomography was used to assess the alveolar ridge width and height. Ridge splitting technique was used to increase the width of the alveolar ridge with series of thin osteotomes and gradual lateralization of the buccal segment was followed by the simultaneous placement of implant. In the study 20 patients received 33 implants. Results: The mean pre-operative ridge width was 3.44 ± .33mm and mean post-operative clinical ridge width was 5.86mm. P value was 0.001 statistically significant. The mean bone gain was 2. 42mm.There was significant increase in the ridge width after the split. Primary stability was achieved in all the implants. The labial cortical plate was intact in 29 implant sites. The labial cortical plate fracture was observed in single implant placement in mandibular anterior region. In three patients in single implant placement sites the labial cortical plate was thin, it was successfully managed by grafting. The survival rate of implants was 100% at 12months follow up.