An ankylosed infra-erupted tooth is a tooth failed to erupt because of root cementum fusion to the alveolar bone. Early diagnosis and proper treatments are important to prevent several problems, such as space deficiency, insufficient development of alveolar bone and delayed exfoliation of the ankylosed tooth. The age of the patient and the severity of clinical symptoms and signs are key factors for treatment planning. This case report presents the treatment consideration of ankylosed primary second molar and conservative approach to managing unerupted lower premolars.