Adequate knowledge of the anatomy of the medial aspect of the mandibular ramus is essential in order to prevent inferior alveolar nerve anesthetic failure and nerve injuries associated with mandibular ramal surgical procedures. The purpose of this study was to assess the morphology of the lingula and analyze the correlation of presence probability between the lingula and antilingula using cone-beam computed tomography (CBCT). Three-dimensional images reconstructed from mandibular CBCT images of 125 Saudi individuals (250 sides), aged 16–36 years, were retrospectively evaluated for distribution in the shape of the lingulae. Additionally, the presence probability of the lingula and antilingula was assessed with respect to gender and the mandible (unilateral and bilateral), and correlation between the variables was analyzed. A nodular shape of the lingula was most commonly found (37.6%) followed by a triangular shape (30%). No significant differences were observed between the genders with regard to the presence of the lingula (p = 0.108) and antilingula (p = 0.530). Gender was non-significantly correlated with the presence of the lingula and antilingula, whilst the presence of lingula showed a significant but weak correlation with that of the antilingula (rs = 0.221; p = 0.000). The present study provides information regarding morphological variations of the mandibular lingula in the Saudi population. The presence of the lingula was unassociated with that of the antilingula and hence consideration of the antilingula as the absolute landmark for mandibular ramus surgical procedures seems insufficient.