Procedural operative errors may occur at any time in root canal treatment and may cause the treatment to fail. Errors in canal preparation, resulting in canal perforations either at the mid-root or in the apical canal third, can lead to the extrusion of the irrigation solutions or the filling material. Regardless of the etiology, the perforation should be repaired as soon as possible to discourage further attachment loss and prevent periodontal pocket formation. Determination of the location and extent of the perforation site is essential before its repair. Digital intraoral periapical radiographs, a Dental Operating microscope, and CBCT evaluation are routinely used for endodontic diagnosis of perforation. Successful treatments necessitate infection control and adequate seal on the site. MTA, Biodentine, dentin chips, bioceramics, and calcium-enriched material with and without the use of a barrier are the materials of choice for perforation repair that have shown good clinical success. This Literature is a compilation of Etiology, Diagnosis, Prognosis, Management, Standard Operating Procedures, Current Trends, and Future Perspectives on Root Canal Perforation.