Introduction: The permanent first molar teeth are the most caries prone teeth in mixed dentition. Reasons for permanent molar teeth loss include poor prognosis, caries,orthodontic and periodontal reasons. This study was done with the aim to assess the common reasons for extraction of first permanent molars in children between 6-17 years of age. Materials and methods: A total of 89000 case sheets were reviewed and cross verified from June 2019 to March 2020. Data related to permanent molar extractions were retrieved by searching with Patient ID, age, gender ,tooth number and treatment relevant to the study. Data was tabulated in the excel sheet. Statistical analysis was done using Statistical Package for the Social Sciences software(version 9.0.3). Results were statistically analysed using association analysis. Results: Higher number of males (64.47%) had first permanent molar extractions when compared to females (35.53%). In males, dental caries with pulpitis (22.37%) was the most common reason for extraction of permanent molars. In females, root stumps(13.16%) was the most common reason for extraction of permanent molars. In both 8-12 years age group and 13-17 years age group, dental caries with pulpitis (34.21%) was the most common reason for extraction of permanent molars. Conclusion: Within the limitations of the current study, first permanent molars were commonly extracted among males and dental caries with pulpitis was the most common reason for extraction of first permanent molars.