PURPOSE: The aim of this study was to compare mesiodistal width and symmetry of maxillary and mandibular teeth in subjects with and without unilateral maxillary lateral incisor agenesis. PATIENTS AND METHODS: The study group consisted of 31 patients with unilateral maxillary lateral incisor agenesis (19 females, 12 males, mean age: 16.55 ± 5.24 years), and a control group of 31 patients (19 females, 12 males, mean age: 16.58 ± 4.41 years) without agenesis. Mesiodistal dimensions of all teeth except second molars were measured. Paired samples t‑test and Wilcoxon signed-rank test were used for intragroup comparisons. Independent samples t‑test was used for intergroup comparisons. RESULTS: In the study group, mesiodistal dimensions of maxillary canine, second premolar, first molar, mandibular second premolar and first molar teeth on the agenesis side were significantly smaller than on the contralateral side (p < 0.05). In the control group, no significant difference was seen in mesiodistal dimensions between right and left sides. In the study group, mesiodistal dimensions of all teeth on the lateral agenesis side were significantly smaller than on the control side (p < 0.05). On the side without lateral agenesis, all teeth except the maxillary and mandibular first molars and mandibular second premolar teeth were significantly smaller than on the control side (p < 0.05). Total mesiodistal dimensions of the maxillary teeth were significantly smaller on the lateral agenesis side than on the contralateral side (p = 0.001). Total tooth size of the study group was significantly smaller than for the control group (p < 0.05). CONCLUSION: Patients with unilateral maxillary lateral incisor agenesis might have asymmetries in tooth width and have smaller teeth than individuals without agenesis.