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Introduction Mandibular premolars usually have one root and one root canal. Different studies found that up to 30% of mandibular premolars have more than one root canal and up to 24% of mandibular premolars have C-shape canals. The purpose of this study was to investigate the root anatomy and the prevalence of complex root canal morphology in mandibular premolars in Israel population. Methods A total of 1,020 Israeli patients' cone-beam computed tomography (CBCT) scans were screened and evaluated. A total of 1,835 mandibular first premo