
Successful endodontic treatment mandates knowledge of internal and external anatomy of teeth along with their deviations. Maxillary first premolars usually have definite pattern of roots and root canals but, deviation in the form of having extra root and root canal is rare. Proper clinical and radiographic evaluation, magnification and modified access cavity preparation helps in diagnosis and treatment of such anatomical variation. This case report describes identification, treatment modifications and successful endodontic management of three rooted and three canalled maxillary first premolar.