Dens evaginatus (a.k.a. Leong’s premolar) is an odontogenic developmental anomaly. This anomaly, an enamel-covered tubercle with an extension of pulp horn in most cases, occurs primarily in premolars. Loss of this tuberculated cusp during natural root maturation and development will result in early pulp exposure, pulpal necrosis, periapical disease, and arrested root development. Early diagnosis and management of dens evaginatus is therefore the key factor in preventing premature loss of tooth vitality.