Objective: In this article, we intend to report the management and the outcome of the surgical treatment of an unusual case of impacted mandibular premolar. Method: A 57-year-old man with an unremarkable medical history was referred by her general dentist for the management of his impacted mandibular left second premolar. The patient complained of an annoying feeling in correspondence of the lingual side of the left mandibular body. Results: Surgical intervention of the impacted mandibular left second premolar was decided in agreement with the patient under local anesthesia. On the 10th day after intervention, the patient complained second premolar was decided in agreement with the patient under local anesthesia. On the 10th day after intervention, the patient complained no pain, and he showed neither paresthesia nor anesthesia in the region of the chin. No sign of infection was observed. The patient was clinically monitored during the year after the surgery. Six months follow up postoperative panoramic radiograph confirmed a good healing. Conclusion:When surgery is the chosen option, a great attention should be paid not to damage the inferior alveolar nerve. The indication for the removal should be carefully assessed in adult patients.