Endodontic surgery encompasses a range of therapeutic procedures for the surgical treatment of diseases of the dental pulp and lesions in the periradicular area. Primary indications include persistent periapical infections, anatomical complexities, and procedural errors that prevent successful non-surgical treatment. Key surgical procedures include surgical drainage, periradicular surgery, replacement, and implant surgery. Before any procedure, it is necessary to take a medical and dental history, perform a clinical examination, and obtain imaging diagnostics. The procedure is preceded by effective anesthesia and the selection of an appropriate flap to access the surgical field. Surgical drainage, through incision and drainage or cortical trephination, evacuates purulent exudate, reducing pressure on surrounding tissues and infection. Periradicular surgery includes curettage to remove inflamed tissue, root apex resection, preparation, and retrograde filling. Corrective techniques such as perforation closure, root amputation, bisection, and hemisection are essential for addressing complex endodontic failures. Replacement surgery involves intentional extraction and replantation of the tooth, which has shown successful results, while implant surgery with endodontic implants is declining in significance. The development of osseointegrated implants follows the increasing trend, demonstrating their success. Advancements in technology have significantly improved the outcomes of endodontic surgery. The use of optical aids, such as surgical microscopes, and precise microinstruments has increased the accuracy and safety of procedures. These advancements, combined with refined surgical techniques, have resulted in high success rates and low risk of complications, making endodontic surgery a reliable choice for preserving teeth that would otherwise be lost.