Dental anomalies of number and forms may occur in the primary and permanent dentition. Various terms have been used to describe dental twinning anomalies: gemination, fusion, concrescence, double teeth, cojoined teeth, twinned teeth, geminifusion and vicinifusion. Double tooth is a term used to describe connate tooth and includes both dental fusion and gemination. The phenomenon of gemination occurs when two teeth develop from one single bud leading to a larger tooth. Fusion is a condition in which the crowns of two separate teeth have been joined toge- ther during the crown development. Fusion occurs infrequently but could cause esthetic, spacing and periodontal problems. The present article highlights the presence of a primary double tooth in an 11 year old boy involving primary mandibular left lateral incisor and canine. Clinical examination and radiographic examination confirmed the absence of the permanent left mandibular lateral incisor. Cases with primary double tooth necessitate careful examination as they may be associated with anomalies in the succeeding permanent dentition and require proper treatment planning