Retained primary tooth/teeth are common clinical findings encountered by orthodontists. This study aimed to assess the prevalence and patterns of retained primary teeth among orthodontic patients. A seven-year retrospective study, with data obtained from patients' records who attended the Child Dental Health Departmental clinic from 2019 to 2025. Information collected included age, sex, molar relationship, skeletal pattern, and retained teeth. Data were analyzed using IBM SPSS Version 26, with a significance level set at p-value < 0.05. The study involved 366 children and adolescents, 157 males (42.9%) and 209 females (57.1%). A total of 109 retained primary teeth were found in 58 subjects (15.9%), 38 females (65.5%) and 20 males (34.5%), with a mean age of 12.4 ± 3.6 years. Retained primary teeth were more common in the 10-19-year age group, 45 (77.6%). Most, 66.1%, were in the maxillary arch, maxillary canines most frequently affected, 30 (27.5%. A single retained tooth was more frequently observed in the 0–9-year age group (53.8%), whereas multiple ones were more common among adolescents, (55.6%). There were no statistically significant association between the number of retained teeth and age, sex, molar relationship, or skeletal pattern (p > 0.05). However, there was a significant association between the number of retained teeth and orthodontic treatment (p=0.01). Overall, retained primary teeth were common findings among the studied children and adolescents, more frequently occurring in females and adolescents, especially in the maxillary arch, with maxillary canines mostly involved. The significant association with orthodontic treatment highlights their clinical importance.