The primary objective of endodontic therapy is to achieve a three-dimensional obturation of the ischolar_main canal space to remove the tissue debris, microorganisms and their by products after a proper biomechanical preparation of the pulp chambers. The missing canal of complex ischolar_main canal morphology is major reason for endodontic failure. The use of magnification, illumination, recent advancements, diagnostic aids and techniques help in minimizing the incidence of missing a canal. This case report describes the rare management of a left mandibular first permanent molar requiring ischolar_main canal treatment with an additional Middle Mesial Canal (MMC) in the mesial ischolar_main. Clinicians experience and approach is a key factor in negotiation and management of these aberrant canal configurations.
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