Background <p>The temporal crest, a prominent ridge descending from the coronoid process to the third molar region, defines the medial boundary of the retromolar triangle and plays a pivotal role in evaluating the temporal crest canal (TCC). The TCC, an uncommon variant of the mandibular canal, often originates posterior to the temporal crest and extends anteriorly, conveying the buccal nerve. Using cone-beam computed tomography (CBCT), clinicians can trace the TCC’s path relative to the temporal crest. This relationship is critical in the retromolar triangle, where surgical interventions such as sagittal split ramus osteotomies or block graft harvesting occur.</p> Methods <p>CBCT images of 1056 patients (2112 sides) consulted to Department of Oral and Maxillofacial Surgery between the years 2020–2024 had been evaluated. Sagittal and axial sections were analyzed to see if there was temporal crest canal and specified the side of it.</p> Results <p>The data reveals a low but significant presence of TCC in both genders (4.6% in females, 5.1% in males), with a statistically significant association between left and right sides (<i>p</i> = 0.000). Females exhibit a greater tendency for bilateral TCC (45.5% vs. 28.6% in males).</p> Conclusions <p>Unrecognized TCCs near the crest convey risk of nerve injury, perioperative hemorrhage or anesthesia failure and highlight the need for precise imaging. This retrospective study aimed to evaluate the presence of temporal crest canal in terms of gender, age and sides of mandible.</p>