OBJECTIVES: This study aims to investigate the incidence and clinical characteristics of concomitant hypodontia and hyperdontia (CHH) by performing panoramic radiographs. METHODS: A total of 41 648 panoramic radiographs of pediatric patients who were admitted to the hospitals from January 2019 to May 2021 were reviewed, and 145 CHH patients were included in the study. The presence of CHH was recorded. SPSS 24.0 software was used for statistical analysis. RESULTS: The prevalence of CHH was 0.35% (145/41 648). Males (102 cases) were obviously more than females (43 cases), and the difference between genders was statistically significant (0.001). The features of congenital permanent tooth loss in this group were predominantly 1 and 2 teeth missing and preferably mandibular lateral incisors and mandibular second premolars missing. The incidence of congenital permanent teeth loss was higher in the mandible than in the maxilla (0.001), but no difference was found in the distribution between left and right (0.84). The features of supernumerary teeth in this group were 1 and 2 teeth, mostly in the maxillary anterior area, mostly conical, mostly vertical inversion and orthotopic growth. CONCLUSIONS: CHH is a rare mixed numeric dental anomaly characterized by congenital missing teeth and supernumerary teeth occurring in the same individual. CHH cases are higher in men than in women. The characteristics of their hypodontia and hyperdontia are similar to those of patients with congenital permanent tooth absence or supernumerary teeth. Early diagnosis of the condition and a multidisciplinary approach for management of such case is recommended.