The National Third Molar (NTM) project was set up to assess current clinical practice in the UK concerning the management of third molar teeth. Patients were recruited from both hospital and general dental practice. During the one month study period 9248 patients with 26,577 third molars were recruited. In this report we present the findings in the 8298 patients with 25,001 third molars who were referred to hospital for assessment. Over half of all patients referred for assessment had either no extractions or a single third molar extracted. Less than a quarter of all patients referred underwent removal of all four third molars. Twenty per cent of all third molars assessed were not extracted. Of all lower third molars listed for extraction, 9574 (78%) were associated with symptoms or disease. Pericoronitis was the commonest indication for extraction and was cited in 39.5% of all extractions. Almost 70% of third molar extractions were done under general anaesthesia while less than a quarter were performed under local anaesthesia alone.