A number of developmental anomalies can be encountered in clinical situations, which directly or indirectly can affect the treatment plan. These anomalies in the primary dentition can be of immense clinical significance since they can have a bearing on the permanent dentition. Here we report a case of fusion of a deciduous maxillary central incisor with its adjacent supernumerary tooth, presenting with the complication of dentoalvelolar abscess. Clinical observation along with periapical radiographs were used to arrive at a diagnosis. This case report emphasizes the need to attempt simple, esthetic conservative procedures before complex treatment alternatives are contemplated. Also, a review of literature is presented.