Aim: The aim of this paper is to report a rare case in a 6-year-old girl where two dental anomalies, fusion and concrescence, coexisted in primary dentition. This highlights the significance of the accurate early diagnosis of these dental anomalies. Background: Odontogenic anomalies are frequently encountered in dental practice. These anomalies can occur due to abnormalities during the differentiation stage and may lead to aberrations in hard tissue formation. Some of the uncommon and unusual dental anomalies of number and form include fusion, gemination, and concrescence. Case description: This elusive case represents the fusion and concrescence together between the left central and a supernumerary tooth. The left primary central incisor presens as a large tooth with a groove through the incisal edge. Clinical observation along with radiographic evaluation using RVG radiographs and orthopantomogram (OPG) were used to arrive at a diagnosis. Conclusion: Early diagnosis of concrescence will reduce the risk of possible complications associated with any need for extraction later on. Monitoring the patient and long-term follow-up are required to manage the case with coexisting anomalies of true fusion and acquired concrescence. Clinical significance: A thorough history-taking and clinical and radiographic evaluation of fusion and concrescence at an early stage results in an accurate diagnosis. A careful monitoring plan is a key to reduce the risk of possible complications later on.