Fixed dental prostheses (FDPs) remain a cornerstone of restorative dentistry, providing functional and esthetic rehabilitation for patients with missing or damaged teeth. The longevity of FDPs is a critical determinant of treatment success and is influenced by numerous biological, mechanical, material, and patient-related factors. Advances in dental materials, adhesive technologies, digital dentistry, and implant-supported restorations have significantly improved survival rates over recent decades. This review examines current evidence regarding the clinical longevity of fixed dental prostheses, including tooth-supported crowns, fixed partial dentures, resin-bonded prostheses, and implant-supported restorations. Factors affecting survival, common causes of failure, maintenance strategies, and emerging technologies are discussed. Current evidence demonstrates survival rates exceeding 90% at 10 years for many contemporary prosthetic systems when appropriate treatment planning and maintenance protocols are followed. Future developments in biomaterials, artificial intelligence, and digital workflows are expected to further enhance prosthesis longevity and patient outcomes.