The mesiobuccal roots of 50 randomly selected maxillary first molars were examined to assess the incidence and position of the canal isthmus. Transverse serial sections of the apical 6 mm of each root were prepared in 1-mm increments. The apical side of each section was stained with methylene blue dye, viewed with a surgical operating microscope, and videotaped. Forty percent of the roots had one canal, whereas 60% had two canals. None of the sections had more than two main canals. The incidence of an isthmus was highest in the apical 3- to 5-mm levels. In teeth that had two canals, the 4-mm sections contained a complete or partial isthmus 100% of the time. The concept of a partial isthmus was presented. Failure to deal with the isthmus may explain why some posterior teeth do not heal completely following endodontic surgery.