Objective To investigate the effect of immediate implantation after minimally invasive extraction combined with periodontal minimally invasive surgical technique and guided bone regeneration (GBR) in the treatment of patients with periodontitis complicated with vertical alveolar bone defect and its influence on implant success rate. Methods A total of 80 patients with periodontitis complicated with vertical alveolar bone defect admitted to the Department of Oral Implantology, Nantong Meiao Dental Clinic Co., Ltd. from October 2023 to October 2024 were retrospectively selected, and they were divided into the control group and the observation group according to different treatment methods, with 40 patients in each group. The control group received delayed implantation combined with GBR after conventional tooth extraction, and the observation group received immediate implantation after minimally invasive extraction combined with periodontal minimally invasive surgical technique and GBR. The implant success rate, CBCT indicators and ISQ were compared between the two groups. Results There was no significant difference in the implant success rate between the two groups at 6 months after surgery (P>0.05). At 12 months after surgery, the implant success rate in the observation group (97.50%) was higher than that in the control group (80.00%) (P<0.05). At 6 and 12 months after surgery, the vertical bone defect height in the observation group was lower than that in the control group, while the bone contact rate and ISQ in the observation group were higher than those in the control group (P<0.05). Conclusion For patients with periodontitis complicated with vertical alveolar bone defect, immediate implantation after minimally invasive extraction combined with periodontal minimally invasive surgical techniqueand GBR can improve the implant success rate at 12 months after surgery, promote bone repair and enhance implant stability.