Aim: The aim of this study was to evaluate the clinical presentation of mandibular impacted teeth and associated pathologies in Unaizah, Al Qaseem; Saudi Arabia. Study Design: Descriptive cross sectional study. Place and Duration of Study: Department of Oral and Maxillofacial Surgery (OMFS), King Saud Hospital Unaizah Saudi Arabia from March 2019 and December 2020. Methodology: The record of patients attending dental section was reviewed from hospital record. Demographic data of patients were recorded through medical record Number by Medicapluse software. Orthopantamograms (OPGs) xrays were reviewed by maxillofacial surgeons on Dell LCD using software IMPEX 6.3.1.2794 enterprise unlimited Agfa. The variables like presence of impacted tooth, type of angulations, reason for extraction, caries on distal surface of 2nd molar tooth, and occlusal or mesial surface of 3rd molar were examined on OPGs. Data was analyzed using SPSS version-21. Results: Males and females were 49% and 51% respectively. The most common type of impaction was vertical 45%, followed by horizontal 27% and mesio angular 22%. The impacted tooth on right side was observed as 51% and on left side as 49%. The relationship of gender with type of impaction was statistically insignificant (p value-0.157). The relationship was reasons and type of impaction was statistically insignificant (p value-0.317) Conclusion: the both genders were almost equally affected. Vertical Impactions were more frequent and the pericoronitis was common reason for extraction of mandibular third molar. The relationship of gender and type of impaction was not significantly associated with type of impaction.