Abstract Proper access cavity preparation, enough cleaning, proper shape, and full obturation are necessary for a root canal to be successful. The placement of each canal in the tooth is crucial to the first therapeutic steps that follow. Although the morphology of most teeth is typical, we should acknowledge that there are some variances. Mandibular premolars are among the hardest teeth to treat endodontically since various anatomical abnormalities have been documented in them. A mandibular second premolar with two root canals and one apical foramen (Vertucci Type II) underwent endodontic treatment was the subject of this case study. The primary complaint of a 13-year-old girl was discomfort in her right mandibular second premolar. Even after a pain was removed, the discomfort persisted for some minutes and kept awake her from sleeping and lingered for several minutes even after removal of a thermal stimulus. Upon clinical examination, the tooth was found to be sensitive to percussion. After making a clinical diagnosis of apical periodontitis and irreversible pulpitis, root canal treatment was carried out in accordance with accepted procedures. Even though mandibular premolars seldom have one root and two canals, the clinician should constantly be aware of differences in the number of roots and canals in order to properly handle such situations.