Root canal therapy, demands adequate accessibility of the pulp chamber followed by a proper biomechanical preparation and three dimensional obturation of the root canals. Permanent maxillary first molar undergoing endodontic management are generally found to have three roots and four canals, although multiple variations in this configuration have been documented in the literature so far. A thorough understanding about predicting and managing such aberrant root canal morphologies is the key to achieve long term success in the field of endodontics. This paper aims to add in the literature, a unique case of permanent maxillary right first molar with a rarest arrangement of 6 root canals. The author(s) have attempted their best to review the literature and enhance the knowledge on aberrant root canal morphology of permanent maxillary molars.