This case report presents the endodontic management of a patient diagnosed with oral submucous fibrosis (OSMF), and with a reduced mouth opening of 18 mm. The patient presented with acute pain; and, emergency pulpectomy was performed using modified endodontic instruments. Treatment of OSMF was initiated and the endodontic treatment was completed at a late stage. The article discusses in brief the etio-pathogenesis of OSMF with endodontic management of such patients.