In this article, we describe the autotransplantation of a supplemental premolar to replace an extracted first permanent molar in a 12-year-old boy. Although the end results are not ideal due to the small size of the donor tooth, the esthetics and function of the dental arch are partly restored using a natural tooth rather than a prosthesis. This case report illustrates the usefulness of autotransplantation as a viable treatment option in children with missing permanent teeth.