Hypodontia is the congenital absence of less than six teeth because of agenesis. The absence of teeth may be unilateral or bilateral. There are reports showing unilateral occurrence of permanent mandibular incisors. But agenesis of bilateral mandibular central incisors is not well documented in the literature and comprehensive review of literature shows paucity of data pertaining to this anomaly. As general dentist is the first member of the health team to diagnose and treat patients having unusual anomalies, the knowledge of congenital absence of permanent mandibular both central incisors is very essential to provide the most appropriate and comprehensive dental care and treatment possible. The aim of the present paper is to report, four cases of bilateral congenital missing of permanent mandibular central incisors and to review the literature regarding etiology, clinical implications and management.