Oral piercings and its associated complications are frequently encountered in general dentistry. This case describes an unusual complication of tooth 41 associated with a long-term metallic tongue piercing. Methods: The patient's history was evaluated and a clinical examination conducted. Results: Repeated traumatic insults from the large metallic tongue piercing rendered tooth 41 non vital and resulted in the formation of a large periapical lesion of endodontic origin. Conclusions: Oral health professional should discourage patients' form wearing oral piercings and be prepared to provide information regarding its potential complications.