Background: Odontomas are common odontogenic tumors and generally appear as small, solitary, or multiple radiopaque lesions found on routine radiographic examinations. They are malformations of dental tissues and may interfere with the eruption of permanent tooth. This lesion occurs because of the developmental disturbances where dental components are laid down in a disorganized manner, due to the failure of normal morphodifferentiation. Case description: A 9-year-old boy reported to the Outpatient Department of Pediatric and Preventive Dentistry with the chief complaint of missing lower anteriors. Orthopantomogram revealed congenitally missing both lower lateral incisors and multiple pearl-like radiopacities in the association of mesial root of primary mandibular right first molar. Extraction of carious primary first molar under local anesthesia followed by the removal of multiple pearl-like structures were sent for histopathological examination. Discussion: Odontomas are common odontogenic origin benign tumor. Clinically, odontoma may result in over-retention of deciduous teeth, non-eruption of permanent teeth, pain, expansion of the cortical bone, and displaced tooth. Prognosis is favorable and relapse is rare but in our case odontoma recurred but it did not hamper the eruption of permanent premolar. Conclusion: Early diagnosis prevents further complications and reduces psychological and financial burden.