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Aim: The purpose of this study to evaluate and categorize the complexity of extracting impacted mandibular third molars (IMTMs) using cone beam computed tomography (CBCT).Materials and methods: CBCT used to analyze 315 lower third molars from 182 patients who met the inclusion criteria. CBCT scans were acquired with a CS 9300 Premium 3D machine. Patient demographics and IMTM details were recorded by two observers using CS 3D Imaging Software for image analysis. Descriptive statistics were applied to assess criteria for impaction and extraction difficulty. Differences in surgical risk indicators for IMTM extraction were statistically examined between age groups, gender, and ethnicities using Fisher’s exact test. Results: Patients aged 18-75 years showed that mesioangular impaction was most common at 41.90%, followed by horizontal at 30.79%, vertical at 25.72%, distoangular at 0.95%, and inverted at 0.63%. Class IA and IIA classifications were most prevalent at 27.30% and 23.49%, respectively, with Class IIIA being the least common at 1.58%. significantly higher surgical difficulty indicators seen in patients under 40 compared to older patients for right and left IMTMs (p = 0.026 and 0.011, respectively), but no statistically significant differences in these indicators were observed between genders or ethnicities.Conclusion: CBCT examination revealed that mesioangular impaction was the most frequent occurrence, followed by horizontal, vertical, distoangular, and inverted impactions. Class IA and IIA prevalent; Class IIIA least common. Surgical difficulty indication more in younger than 40 years old patients, no gender or ethnicity differences.