Aim: The current report presents an interesting case scenario that describes the management of immature bilateral second premolar with Dens Evaginatus (DE) that developed pulp necrosis and symptomatic apical periodontitis. Case Report: An 10yrold healthy Chinese boy presented to the AIMST Paediatric clinic with the complaint of intermittent pain and fluid discharge from the buccal sulcus of a permanent mandibular left first premolar and permanent mandibular right first premolar for the past 1__ampersandsignfrac12; years. Upon intraoral examination and appropriate radiographic investigations, a diagnosis of pulp necrosis with symptomatic apical periodontitis was made for both teeth. The patient was explained regarding the aberrant tooth morphology and periapical condition. The treatment option of regenerative endodontic procedure was performed on the patient Discussion: DE is an anomaly presented as an outward projection of the tooth with a tubercle on the occlusal surface exhibiting outer enamel coverage, dentinal core and varying amounts of the pulp tissue. Complications usually increase in a developing young permanent tooth causing an interruption in the root formation root completion and closure, and sometimes periapical inflammation which can further delay a normal root development. Planning a preventive prophylactic restoration of such teeth to maintain the haemodynamic of the pulp and normal development of the root is a better option. This case was managed using Mineral Trioxide Aggregate (MTA) in regenerative endodontic treatment (RET) which resulted in continued root growth. Long term follow-up was recorded successfully. With past literature and the present case, it is safe to conclude that the revascularization of the tooth is progressing successfully for both teeth. Conclusion: Chronic apical periodontitis due to dens evaginatus requires special treatment strategies to eliminate the infection especially in young permanent teeth. Based on the results of the present case, it can conclude that Regenerative endodontic treatment is an ideal treatment method for Dens Evaginatus with an immature permanent tooth with apical periodontitis/ abscess.