Objective Lingual nerve damage is a common complication during oral and maxillofacial surgery procedures to the third molar region. The anatomy of the lingual nerve is variable, therefore the precise knowledge of anatomy of this nerve is important for decreasing the damage risk. The purpose of this study was to determine the position and the shape of the lingual nerve in the third molar region using radiographic imaging. Setting The Anatomy Department of Cologne University in Germany. Materials and Methods Firstly, an anatomic dissection of the lingual nerve in the third molar region was done on 10 whole heads and one sagittal hemisection head specimen of adult cadavers. After marking the nerve, x-ray films were taken. Vertical and horizontal measurements were made from the radiographs with an electronic digital caliper. Results The mean vertical and horizontal distances of the nerve to the lingual crista and lingual plate of the mandible were found to be 9.5 +/- 5.2 mm and 4.1 +/- 1.9 mm respectively. Additionally, of the 21 lingual nerves examined, 17 (81%) were round and 4 (19%) were flat. Conclusions The results reflect the relationship of the nerve to this area and may help the clinician to avoid the damage risk.