Mental Foramen: A Comprehensive Review of The Distal Exit of The Mandibular Canal The mental foramen (MF), averaging 4.6 mm × 3.4 mm, is a vital anatomical landmark with significant implications for dental and surgical procedures. Its location, dimensions, and relationship to the inferior alveolar nerve (IAN) are critical in reducing complications such as nerve injury and treatment failure. A literature review of studies published between 1970 and 2024 explored the MF’s anatomy, imaging, and clinical outcomes. This review examines variations in the MF’s shape, size, number, and position, emphasising their clinical relevance. The MF may occasionally be radiographically or clinically absent and is not always a single opening. Understanding its variability is crucial for accurate localisation. This narrative review summarises that, despite an increasing amount of research, human variability influences the shape, size, and location of the mandible. Even within the same ethnicity, different studies have produced different locations and appearances in terms of its shape. Nevertheless, more Western studies generally reported the MF being located between the first and second premolars, and more Asian-centric studies reported it as closer to the second premolar. Accessory mental foramina (AMF), on the other hand, vary between ethnic groups, with a higher prevalence reported among non-Caucasians. Most AMFs were found to be unilateral, occurring more on the right side of the mandible. Bilateral AMFs have also been reported to range from 0% to 33.3%. On the contrary, MF may be missing in between 0.7% and 2.4% of the unilateral mandible.