Abstract: Objective To investigate the clinical result of key-way attachment in Abstract：Objective To investigate the clinical results of key-way attachment in fixed restoration of tilted mandibular abutments．Methods We made fixed restoration with key-way attachment in 20 cases in which the second premolar or the first molar in mandible was lost，endodontic and periodontal tissue was normal in the abutments at the two ends of the tooth-loss area, adjacent teeth were tilted in direction of the tooth-loss area，and the comon insert path of insertion couldn't be found after common teeth preparation. Results After 3 years' observation, looseness between the two parts of attachment was found in two cases. 20 cases had good chewing function. Looseness of retainers, abutment looseness, periodontitis，pulpitis or apicitis were not found. Conclusion The fixed restoration with key-way attachment is a good for tilted mandibular abutments．