Background: Mesiodens is the most common type of supernumerary tooth found in the premaxilla. It might be discovered during the clinical examination as a casual finding on a radiograph or as the cause of an unerupted maxillary central incisor. The genetic transmission of supernumerary and impacted teeth is poorly understood. Mirror imaging in twins has been reported frequently in relation to several unilateral dental anomalies including mesiodens. This phenomenon is the appearance of an asymmetrical feature or anomaly occurring on the right side of one twin but on the left side of the other twin. The event of mesiodens mirror imaging in monozygotic twins has been described in literature. Results: This is the first reported case of mesiodens mirror imaging in dizygotic twins. The described mesiodens caused the eruption failure of maxillary permanent incisors. The supernumerary teeth were removed to facilitate the spontaneous eruption of the impacted permanent maxillary incisors. Clinical Implications: Studies related to supernumerary teeth can be useful to clinicians in the early diagnosis of this anomaly. Clinical and radiographic examinations provide a correct therapeutic approach.