Hemifacial microsomia (HM) is an asymmetrical congenital deformity of the head and face caused by anomalous development of the structures derived from the first and second branchial arches. This study evaluates the incidence of agenesis and dental inclusions in HM patients. Sixty-three HM patients, 27 male and 36 female, ranging from 7 to 43 years had monolateral (61) and bilateral (2) presentation. From clinical examination, photographs, and various radiographs, the following manifestations were noted: 11 patients had tooth agenesis with at least one on affected side and 5 patients had dental inclusions. The greater the severity of HM, the greater likelihood of agenesis. Third molars were most commonly missing. Dental inclusions did not show a relationship to severity.