The treatment of atrophic maxilla has multiple options were zygomatic implants with simultaneous Lefort I osteotomy correspond to an effective non- grafting and prosthetically viable alternative. The objective of this article is to present a literature review of Lefort with zygomatic implant placement for the treatment of severe atrophic maxilla and the description of this technique. A systematic search was carried out for identify the existing relevant literature. A descriptive analysis is made for each identified study that described or compare the use of zygomatic implants and Lefort osteotomy. The general technique is described. All databases were consulted with the systematic search strategy and all the included studies references were revised for more articles that meet the inclusion criteria. Four articles have been published that described the Lefort I osteotomy and simultaneous zygomatic implant placement, all of them are case reports. No comparative studies were identified. Regardless that the main evidence identified is based only in series of cases published by different authors and that no comparative evidence exists, this technique could be a viable and effective option for the treatment of this patients without the need of a complementary bone graft and other associated morbidities.