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A supernumerary tooth is a developmental anomaly and it has been argued to arise from multiple aetiologies. Mesiodens is a midline supernumerary tooth which is commonly seen in the maxillary arch, and incidence of molariform mesiodens in the maxillary midline is rare in permanent dentition and extremely uncommon in primary dentition. A midline supernumerary tooth in the primary dentition can cause an ectopic or a delayed eruption of permanent central incisors, which will further alter occlusion and may compromise aesthetics and formation of dentigerous cysts. This paper reports a rare case which had the presence of a molariform mesiodens in the primary dentition. The treatment plan consisted of extraction of the supernumerary tooth and regular observation of permanent central incisors for proper eruption and alignment.