Molar Incisor Hypomineralization (MIH) is a developmental enamel defect affecting one or more permanent first molars, frequently associated with similar defects in the permanent incisors. This case report presents a 19-year-old patient with severe MIH affecting multiple first permanent molars and incisors, demonstrating the clinical challenges in diagnosis and management. The patient presented with increased dental sensitivity, aesthetic concerns, and post-eruptive enamel breakdown. The purpose of this case report is to discuss the clinical presentation, differential diagnosis, and comprehensive management approach for MIH, highlighting the importance of early detection and preventive strategies.