Mandibular impacted third molars are the most frequently impacted teeth in humans and can predispose the adjacent second molar to an array of detrimental effects such as caries, periodontitis, and cervical resorption thus the aim of this study was to determine the same. A retrospective observational cross-sectional study involving patients with orthopantomography presenting with impacted lower third molar. The type, depth, and level of impaction, the extent of caries, periodontal changes, and the presence of cervical resorption were assessed. Data were analyzed using SPSS version 21.0. with Chi-square. Mesioangular impaction was most commonly noted. The pattern of impaction had a direct influence in the formation of carious lesions, cervical resorption, and periodontal ligament (PDL) changes. Noting the pattern of third molar impaction helps the clinician to forecast problems that may occur on adjacent teeth and initiate necessary prophylactic treatment.