Aim: The aim of this paper is to report a rare case in which two dental anomalies in primary dentition coexisted—fusion and concrescence in a 4-year-old boy. This highlights the significance of the accurate early diagnosis of these dental anomalies. Background: Odontogenic anomalies are frequently encountered in dental practice. These anomalies can occur due to abnormalities during the differentiation stage and lead to abnormalities in the hard tissue formation. Dental anomalies in number and form include fusion, gemination, and concrescence. Case description: Primary dentition with fusion between the right central and lateral primary incisors with increased mesiodistal width. Concrescence between the left central and lateral primary incisors with a groove through the incisal edge. Clinical observation along with radiographic evaluation using intraoral periapical (IOPA) radiographs and orthopantomogram (OPG) were used to arrive at a diagnosis. Conclusion: Early diagnosis of concrescence will reduce the risk of possible complications associated with any need of extraction later on. Monitoring the patient and long-term follow-up is required to manage the case with coexisting anomalies of true fusion and acquired concrescence. Clinical significance: A thorough history taking and clinical and radiographic evaluation of fusion and concrescence at an early stage result in an accurate diagnosis. A careful monitoring plan is a key to reduce the risk of possible complications later on.