Background: The first permanent molars are frequently affected by caries partly because they are the first teeth to erupt in the oral cavity and partly because of their susceptibility by virtue of their morphological and functional characteristics. Although extraction and replacement with osseointegrated implants may be acceptable in adult patients, these treatment options are not ideal in adolescents.Methods: This preliminary study was conducted in patients diagnosed with grosslycarious and non-restorable molar teeth, and subsequently managed by molar to molar autotransplanting. Patients were recruited in a period of 2 years and had follow-up visits up to 3 years post-transplantation.Results: Eight cases of molar to molar autotransplanting were done in seven patients. Patients were within 15–17 years of age, with a mean age of 16.0+0.93 years. The overall 3-year survival rate of autotransplanted mandibular molars in this study is 75% with two cases of failure of treatment (25%) occurring 6 months following the procedure.Conclusion: Molar to molar tooth autotransplanting in African adolescents may be considered for immediate teeth replacement in the management of teeth scheduled for dental extraction. More cases are required to validate the viability of the procedure.Keywords: Adolescents, Tooth autotransplantation, Molar teeth, Survival rate