Background: Recognizing the anatomical differences in the location of the mental-foramen (MF) is essential for various dental procedures. The purpose of this study to determine horizontal and vertical anatomical localization of MF in relation to the apex of second premolar, mandibular midline, superiorborder of the mandible and inferior-border of the mandible. Methods: A retrospective cone beam computerized tomography was used for assessment the horizontal and vertical anatomical localization of MF in relation to the apex of second premolar, mandibular midline, superior-border of the mandibular and inferior border of the mandibular. A cone beam computerized tomography was obtained from Saudi patients visiting university dental clinics in western region, Saudi Arabia. X-rays were taken for a variety of diagnostic purposes. Statistical analysis was carried out using SPSS® version 26.0 for Windows (IBM®, Armonk, NY, USA), descriptive statistics of connected to age and gender. Results: In this study, CBCT images of the mandible were obtained from 500 patients. 39% of them were males and 61% were females. Almost half cases 49.8% showed mental foremen under the second premolar's apex in relation to the teeth on each side of the mandible, while, 32.2% of MF between 1st and 2nd pre-molar. Conclusion: Anatomical localization of MF was most frequently seenbelow the second-premolar among Saudi population. When doing dental implant, surgical extraction and surgical endodontic treatment in the premolar region, the anatomic location of the MF must be taken into consideration.