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Endodontic treatment aims to disinfect the root canal system, followed by sealing this space to prevent recontamination. For this purpose, nonsurgical endodontic treatment is the first option in most cases, but a surgical approach may be indicated when periradicular-pathosis cannot be solved by a nonsurgical method. Endodontic surgery is a surgical technique for the maintenance of devitalized teeth with apical pathology after failed endodontic therapy or when nonsurgical treatment is not possible or not recommended. Endodontic microsurgery (EMS) has become a more effective treatment compared with more traditional surgical approaches. Regardless of the technique improvements, it can be challenging to locate the root apex, especially in cases of difficult access, intact thick buccal cortical bone and anatomical obstacles. Technological advances change our understanding and the way we treat our patients. Occasionally there is a leap forward that changes dramatically the techniques we use, and the endodontics field is no exception. Endodontic surgery has suffered in the past from poor visualization and non-biocompatible materials.