Objectives: This retrospective study evaluated the clinical performance and long-term survival of glass-ceramic lithium disilicate all-ceramic restorations in anterior and posterior areas over a 10-year period. Method and Materials: Following a consistent protocol over 10 years, 261 lithium disilicate crowns (IPS Empress 2, Ivoclar Vivadent), including 101 anterior (38.7%) and 160 posterior (61.3%), were cemented using an adhesive technique and observed by the clinician who prepared and luted them. The data were analyzed using the Kaplan-Meier test. The clinical evaluation adopted the California Dental Association (CDA) modified criteria after recalling all patients between January and May 2008. Results: Six crowns failed and were replaced, 4 due to chipping and 2 due to core fracture. The overall survival rate was 95.5%. Conclusion: In this retrospective evaluation, lithium disilicate ceramic restorations had a low clinical failure rate after up to 120 months. (Quintessence Int 2009;40:573–579)