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Apical surgery is performed for eradication of tissues showing signs of necrosis or infection. This involves apicoectomy of tooth (apical resection of tooth). Healing of periapical tissues after resection is the sole indication of success of periapical surgery.An assessment of the outcome of periapical surgery is usually based on clinical and radiographic criteria. In the assessment of the extent of radiographic healing, 2-dimensional radiography is a commonly employed tool. The limitations of 2-dimensional radiography have paved the way for 3-dimensional evaluation of the healing site through cone beam computed tomographyCone-beam computed tomographic (CBCT) imaging is a widely accepted tool fordiagnostic evaluation in dentistry. In surgical treatment planning, CBCTimaging is helpful to assess the extent and location of apical periodontitis; the bone thickness over pathologic defects; and the proximity to anatomic structures such as the mental nerve, sinus cavity, or adjacent teeth.This systematic review compared the healing outcome of periapical endodontic surgery using conventional radiography and cone beam computed tomography.