AIM: This study aims to radiographically determine the prevalence of missing and decayed FPMs in a Libyan sub-population and to investigate any distinctive patterns related to age and gender. MATERIALS-METHOD: Applying inclusion and exclusion criteria, a total of (931) panoramic images were included, from July 2021 to August 2023, divided into 2 age groups (A: 9-39 years and B: 40 years and above). Intra-observer and Inter-observer agreement were evaluated, yielding no differences of significance (p>0.05)“ The first observer "Intra-observer'' reliability indicated a level extending from (0.811 to 1.000) for the (931) images. The second observers’ observational reliability were between (0.965-1.000) for the randomly selected 140 (15%) image. The ''Inter-observers'' agreement analysis, extended from (0.852 to 1.000), values > 0.7 were considered reliable. RESULTS: (32%) of FPMs were missing and (17%) were decayed. There was a statistically significant difference in the odds of missing upper and lower FPMs with age; (P-value= 0.0001), (OR=0.1136), (95% CI 0.0788, 0.1636) and (P-value=0.0001), (OR= 0.1165), (95% CI 0.0754, 0.1806) respectively. While the difference in the odds with gender was only statistically significant for the upper missing FPMs; (P-value=0.01), (OR= 0.7), (95% CI 0.647, 0.942). CONCLUSION(S): Fairly high missing and decayed prevalence of FPMs in this Libyan sub-population are highlighted with significant age and gender associations, suggesting the importance of preventive practices to reduce extractions, raise awareness and promote restorative dentistry to maintain proper health and function of the stomatognathic system.