Objectives: Palatogingival groove is a developmental anomaly that starts near the cingulum of the tooth and runs down the cementoenamel junction in apical direction, terminating at various depths along the roots. While frequently associated with periodontal pockets and bone loss, pulpal necrosis of these teeth may precipitate a combined endodontic-periodontal lesion. This case presents a case of a lateral incisor anatomically complicated with palatogingival groove. Methods: Two patients with lesion associated with the palatogingival groove were chosen for this report. Palatogingival grooves were treated with different restoration materials with endodontic treatment. Conclusions: Maxillary lateral incisor with a palatogingival groove may occur the periodontal disease with pulpal involvement. Elimination of groove may facilitate the periodontal re-attachment and prevent the recurrence.