ABSTRACT: The aim of this study was to assess the prevalence of missing permanent first molars in the South Indian population who reported for orthodontic treatment to a dental hospital. A total of 550 OPGs of patients who reported for orthodontic treatment to the hospital were assessed for missing permanent first molars.The data was retrieved from the extensive electronic database record of the hospital. Descriptive analysis was done to represent the data. Prevalence of missing permanent first molars was found to be 5.8%. A significant percentage of the orthodontic population have missing permanent first molars. A thorough clinical examination, from an orthodontic perspective will help formulate a better treatment plan.