Objectives: This study aims to investigate the mandibular vertical asymmetry in a group of adult patients who had early bilateral mandibular first molar extractions., Methods: Mandibular asymmetry index measurements (condylar, ramal, and condylar plus ramal) were made on the panoramic radiographs of a study group including 30 subjects (mean age, 18.22 ± 1.30 years) and a control group of 25 subjects (mean age, 18.24 ± 1.17 years). Group I comprised the control group patients with no extractions and had excellent class I relationships, no missing teeth, and slight or moderate anterior crowding. Group II included patients with a bilateral mandibular first molar teeth extracted before the age of 12 years. Student's t test was used for the comparison of asymmetry index values between the groups. A paired t test was used to determine possible statistically significant differences between the sides for condylar, ramal, and condylar plus ramal height measurements., Results: No group showed statistically significant side-specific differences for posterior vertical height measurements. Condylar asymmetry index (CAI), ramal asymmetry index, and condylar plus ramal asymmetry index measurements were not statistically different between the groups (p > 0.05)., Conclusions: CAI values were significantly high when compared with the 3 % threshold value in the both groups, but comparisons between the groups were not statistically significant., Clinical Relevance: This article investigates the effects of early bilateral mandibular molar teeth extraction that has never been investigated in the literature. The present study showed that the lengths of the condylar, ramal, and condylar plus ramal height were less in the study group than in a well-matched control group of without extraction.