Extra cusps or the central cusps have been recognized as supernumerary cusps by many authors. Extra cusps are usually seen on premolars. Central cusps are of clinical importance as it could be associated with some anomalies that can lead to clinical complications. Extra or accessory cusps rarely pose any problem to the dentist. Even though, it may not cause an emergency in the clinic fracture of this cusp may lead to clinical problems. We present this rare case with bilateral central cusps both on permanent and deciduous molars. Review regarding central cusp, need for continuous follow‑up are also been included