Purpose. The aim of this paper is to present cases of mandibular first molars with an additional distolingual root and their management using appropriate instruments and techniques. Basic Procedures and Main Findings. Mandibular molars can sometimes present a variation called radix entomolaris, wherein the tooth has an extra root attached to its lingual aspect. This additional root may complicate the endodontic management of the tooth if it is misdiagnosed or maltreated. This paper reviews the prevalence of such cases in Indian population and reports the management of 6 such teeth. Principal Conclusions. (1) It is crucial to be familiar with variations in tooth/canal anatomy and characteristic features since such knowledge can aid location and negotiation of canals, as well as their subsequent management. (2) Accurate diagnosis and careful application of clinical endodontic skill can favorably alter the prognosis of mandibular molars with this root morphology.