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Introduction: Rich neurovascular supply in the anterior mandible necessitates a preoperative radiological assessment of the lingual foramina/canal where cone beam computed tomography (CBCT) could produce promising results. Aim: To assess the prevalence of lingual foramina and canal in mandible and variations in their anatomy in a hospital-based population in Chennai. Methodology: Sagittal sections of the anterior mandible from CBCT images of 140 patients were evaluated for number, location of the lingual foramen, length of the lingual canal, a distance of lingual foramen from the alveolar crest and inferior border of the mandible, and thickness of the lingual cortex. Results: A total of 166 lingual foramina-canals were identified in 140 individuals; 82.1% presented with one, 15.1% with two, and 2.1% with three lingual foramina canals. The majority of foramina (79.51%) were located above the genial tubercles. The mean lengths of the superior, middle, and inferior canals were 5.45 ± 1.34, 5.00 ± 1.73, and 3.92 ± 1.10 mm, respectively. The mean thickness of the lingual cortex was 2.35 ± 0.55 mm. The distance from the inferior lingual foramina to the alveolar crest was significantly greater in males (P = 0.001). Conclusion: Anatomical characteristics of lingual foramen-canal varied significantly across the total sample.