Bisphosphonates are drugs that have been used in medicine since the 60s of the last century. They belong to the group of antiresorptive medications whose mechanism of action is based on inhibition of osteoclast activity and stimulation of their apoptosis. There are two groups: aminobisphosphonates and non-aminobisphosphonates, which differ not only in their structure but also in their effectiveness. They have a long half-life, and their effect can be felt in the body several years after their use. Depending on the indication, they are administered orally for diseases of the bone system such as osteoporosis or parenterally in the treatment of bone metastases of cancer or primary bone tumors. Several side effects have been reported, the most serious of which is medication-related osteonecrosis of the jaw. Symptoms can vary from a quiet, localized lesion to a process that spreads invasively into the surrounding structures of the orofacial region. There are several theories of its origin, the most significant of which are reduced bone remodeling due to bisphosphonate therapy, local infection and trauma. Risk factors that differ from patient to patient and have an important influence on the development of the disease, are the method of administration of the therapy, duration and dose, whereby BRONJ mainly develops in patients on parenteral administration. Also, with the duration of the therapy, the risk increases by 1.7 times every next year. Endodontic therapy is an alternative to invasive surgical procedures and can delay or completely prevent them. It is considered a relatively safe procedure, however there are modifications in clinical work that should be followed in order to minimize the risk for BRONJ. Special care is taken to preserve the integrity of the soft tissues of the oral cavity and prevent the extrusion of debris, irrigant or filling material into the periapical tissue.