The objective of this article is to increase our understanding of the root canal system of the anomalous structures like paramolar tubercles. The knowledge of the internal anatomy of the paramolar tubercles is very important as they influence the treatment modalities and associated problems in many dental disciplines. This case report investigates the anatomical and morphological characteristics of a rare case of two well-developed lobulated cusps occurring on the buccal surface of maxillary right second molar with the aid of spiral computed tomography. Unlike to previous reports, in our case the tubercles had their own pulp chamber with its root fused to the mesiobuccal and distobuccal roots of maxillary right second molar, while its canal remained independent from the main root canals.