The aim of this study was to describe the characteristics of the mandibular third molar at highest risk for acute pericoronitis using clinical and radiographic analysis. A total of 102 volunteers, including 40 (39%) male and 62 (60%) female patients presenting with acute pericoronitis, participated in the study. The mean age of the participants was 23.4 years (range 17-30 years). The variables tested included the percentage of soft tissue coverage, availability of impinging maxillary dentition, and the angulation and eruption level of the mandibular third molar. While vertical impaction was the most frequent angulation (51%), horizontal impaction was quite rare (3%). Mesioangular impaction (25%) was slightly higher than distoangular impaction (21%). Difference between type of angulation was statistically significant for all groups (p<0.05). The frequency of partial soft tissue coverage, particularly 75% coverage, was far more observed than the full soft tissue coverage (47%). The difference for the amount of soft tissue coverage was statistically significant (p<0.05). In 57% of the cases, pericoronitis was associated with the third molars that erupted at the same level of the adjacent tooth occlusal plane. The difference among the three levels of eruption was significant (p<0.000). Impinging maxillary dentition did not have a significant impact on development of pericoronitis (41%). Evidence of impinging maxillary dentition did not have a statistically significant impact on presence of pericoronitis (p=0.075). Mandibular third molars at or near to the same level of the occlusal plane of the arch and exhibiting vertical inclination were considered at highest risk for developing pericoronitis. Such third molars, can be given high priority for prophylactic care due to the possibility of severe consequences of acute pericoronitis.