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Objective The aim of this study was to investigate the prevalence of dental anomalies in the Eastern Province of Saudi Arabia using the digital Orthopantomography (OPG). Methods A retrospective radiographic study was performed in which digital OPGs of 1189 subjects, ages ranging between 7 and 65 years were reviewed, and 1104 fulfilled inclusion criteria. Statistical analysis was performed. The OPGs were reviewed for congenitally missing teeth, impactions, ectopic eruption, supernumerary teeth, odontomas, dilacerations, taurodontism, dens in dente, gemination and fusion. Results OPGs of 1104 patients with mean age 35.32 ± 16.63 were included. The total prevalence of developmental anomalies in this study was 36.3% (401/1104). Male and female subjects with anomalies were 133 (33.2%) and 268 (66.8%) respectively. The prevalence of dilacerated teeth 300 (30.2%), congenitally missing teeth was 246 (24.7%), supernumerary teeth 18 (1.8%), talon cusp and taurodontism were seen in one patient each 1 (0.1%). Of these, a total of 15 (1.5%) anomalies were noted in pediatric patients. Conclusions Dilaceration was the most prevalent anomaly (30.2%) in the studied sample followed by congenitally missing teeth (23.4%). Talon cusp, concrescence/fusion, and taurodontism were the least prevalent anomalies.