We present a rare case of three-rooted left permanent maxillary first premolar (MFP) coexisting with bilateral four-rooted permanent mandibular second molars (MSM). These variants were found incidentally on cone beam computed tomography (CBCT) images. At best of our knowledge, this is the first report presenting these rare tooth root variants in one patient. Although this condition is uncommon the radiologists and clinicians should be aware because of its importance for the successful root canal treatment, future tooth extraction, apicectomy and other procedures. This report adds a new knowledge about tooth roots variants and illustrates the possibility of their coexistence in one patient.