Maxillary canine and first premolar transposition are a difficult dental anomaly to treat, especially if the clinician's goal is to move the canine into its normal position orthodontically. Early detection of this pathology with cone-beam computed tomography simplifies treatment. In terms of treatment planning and orthodontic management, such cases are frequently extremely difficult. One of the most common transposed teeth is the canine, which is ectopically positioned with either the lateral incisor or the first premolar. Narrative review of literature conducted among databases such as PubMed, for all relevant studies that were published up to 2022. Partial or complete transposition is possible. Despite their low prevalence in the general population, transpositions pose a challenge to orthodontists, particularly if treatment is aimed at correcting tooth order. The diagnosis, planning, and treatment of a unilateral maxillary canine-first premolar transposition in a female patient treated orthodontically without premolar extraction and with transposition correction are described in this article. Treatment options, advantages and disadvantages of each method, and treatment mechanics are also discussed.