Aim: The purpose of this case report is to present a case of separated instrument retrieval in a mandibular first molar using a combined preparation technique and a loop device. Body: A 21-year-old female was referred to the Department of Endodontics at the Faculty of Dentistry, Cairo University, with a chief complaint of pain on biting in the lower left quadrant for the past 3 months. Clinical and radiographic examination revealed a previously endodontically treated left mandibular first molar, a 5 mm-separated instrument in the mesiobuccal canal, and a periapical radiolucency related to the mesial root. The tooth was diagnosed as having previously been treated with symptomatic apical periodontitis. Two-visit non-surgical endodontic retreatment and mechanical retrieval were the treatments of choice. The first visit comprised the removal of old root canal filling material, preparation of a staging platform using the TOQ extractor kit and ultrasonics, retrieval of the separated instrument using a loop device (Leo pen), and placement of intracanal medication. The tooth was obturated at the second visit (1 week later) and referred to a prosthodontist for endo-crown construction. At 3 months of follow-up, the patient was asymptomatic, and function was restored. Conclusion: The case report highlights the importance of the combination of different retrieval techniques for separated instruments by demonstrating their clinical applicability and favorable outcomes in complex settings.