Pyramidal teeth are thought to be a minor form of taurodontism, which is a morpho-anatomical change in the shape of a tooth, usually occurring in multirooted teeth as a result of failure of the infolding of the epithelial root sheet of Hertwig. The characteristic features of these teeth are an enlarged body and pulp chamber, as well as apical displacement of the pulpal floor. Endodontic treatment of a taurodont tooth is challenging, because it requires special care in handling, and in the identification of the number of root canals and morphology of the tooth. In this case report, the endodontic treatment of a mandibular first and second molar with pyramidal root canal morphology is presented. Keywords: dental malformation, endodontic treatment, root canal morphology, taurodontism