C-shaped canals are known to present a complex canal anatomy with numerous fins connecting individual canals, thus requiring supplementary effort to accomplish a successful root canal treatment. This study examined the frequency of the C-shaped mandibular second molars and interrelation between the clinical records and radiographs to recognize them treated in the Department of Conservative Dentistry of the Chosun University Dental Hospital during a six-year period (1998 - 2004). This study reviewed the clinical records of 227 patients who underwent root canal treatment of the mandibular second molars. After opening the chamber, those cases with C-shaped orifices in the pulpal floor were selected, and the C-shaped root canal types were classified according to Melton's criteria. Three experienced dentists evaluated the radiographs of the C-shaped mandibular second molar on a viewer using a magnifying glass in order to determine if the root apex was fused or separated, the distal root canal was either centered or mesial shifted in the distal root, and if there was bilateral symmetry in a panorama. In conclusion, there is a high frequency of C-shaped mandibular second molars in Koreans. Simultaneous interpretation of the root shape and distal root canal using the preoperative, working length and post-treatment radiographs is important for diagnosing a C-shaped mandibular second molar.