The presence of supernumerary teeth in the premaxillary region may cause a variety of pathological effects. This study was carried out to determine the various aspects of supernumerary teeth in the premaxillary region, particularly the effects of the supernumerary teeth on the permanent incisors and surrounding tissues. Approximately 20 percent of the patients (n = 49) with supernumerary teeth did not present with any abnormality. A high proportion of patients (37.9 percent) had delayed or failure of eruption of permanent teeth and 24.1 percent had rotation or displacement of permanent teeth. Other effects observed were median diastema and cystic changes around the unerupted supernumerary tooth. The high proportion of pathological effects seen showed that early diagnosis of the anomaly is important to intercept damage to the adjacent normal teeth and surrounding tissues. However, no cases of root resorption of the permanent teeth due to the presence of supernumeraries were observed.