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Introduction: Delayed evolution of second molars is a rare phenomenon, with an estimated prevalence in the mandible of 0 to 2.3%. Many etiologies have been proposed to explain these inclusions, including the reduction of the arch perimeter, distalization of the first molar, and a mesio-angulated position of the second molar. However, the presence and position of the third molar does not seem to be a risk factor for this inclusion. Materials and methods: Several therapeutic options with surgical management have been proposed in the literature, including surgical repositioning, surgical release of the crown alongside varying levels of orthodontic treatment, and sometimes avulsion of the second molar to allow third molar development. There is no recommendation on this subject, with the literature describing mostly retrospective studies and case reports. Conclusion: This article presents the various different therapeutic options for treating second molar inclusions.