Teeth impactions are rarely found in the maxillary second premolars, and it will affect the occlusal function and even produce pathological change. In this article, we present a deep impact of upper left second premolar correction with using the autotransplantation combined with apexification. After 1-year follow-up, the occlusal function was restored and the tooth was in a stable condition. The influencing factors of autotransplantation were also be discussed.