OBJECTIVE: To elucidate the prevalence of ectopic eruption, impaction, and primary and secondary retention as well as agenesis of the permanent second molar (M2) among adolescents. MATERIALS AND METHODS: After a sample size calculation, dental records, including radiographs, of 1543 patients (722 girls and 821 boys), from three clinics in the city of Malmoe, Sweden, were retrospectively analyzed. Series of annual records and radiographs were examined for all patients from 10 to 16 years of age and were carried out during 2004-2006. The prevalence of ectopic eruption, impaction, and primary and secondary retention as well as agenesis of M2s was registered in a standardized manner and according to preset definitions. In addition, the times of emergence of the M2s were recorded. RESULTS: The prevalence of ectopic eruption of M2 was 1.5%, the prevalence of primary retention was 0.6%, and the prevalence of impaction was 0.2%. This means that the overall prevalence of eruption disturbances was 2.3%. In addition, the prevalence of agenesis was 0.8%. The prevalence of ectopic eruption was significantly higher in the mandible. Those patients with eruption disturbances and agenesis of M2 showed significantly delayed eruption of their other M2s compared to the individuals without any eruption disturbances. CONCLUSIONS: The prevalence of eruption disturbances was higher than reported earlier, and, even if the disturbances do not occur frequently, it is important to develop an early diagnosis in order to start the treatment at the optimal time.