Apicoectomy is a surgical procedure in which an osteotomy is used to access the periapical part for root tip resection and curettage of the periapical area. It is indicated in case of failure of primary endodontic therapy and in case of no orthograde access to tooth canals showing symptoms of inflammation. In cases indicated for apicoectomy, a periapical lesion is usually present. Three-dimensional radiological analysis enables detailed planning of the course of surgery and examination of the surrounding anatomical structures. The patient is administered with a local anesthetic, after which the mucoperiosteal flap is detached. The type of the flap is chosen according to the location of the affected tooth and the periodontal condition of the patient. An osteotomy is performed with rotating instruments with drills, which make it possible to open the space of the periapical lesion. After approaching the root apex, it is resected 3 mm in length at an angle as close as possible to 90°. The canal of the resected root is accessed with an ultrasonic or rotary instrument and a retrograde cavity is prepared. It is very important in that it prevents the penetration of bacteria from the canal into the periapical space and vice versa. Amalgam was used for years for these purposes, but now MTA has taken its place. There are a large number of bioactive materials that meet the high requirements of retrograde filler. Curettage of the defect removes inflamed and infected tissue and debris. Repositioning the flap and then performing a suturing procedure completes the surgical part of the treatment. It is necessary to give detailed instructions to the patient and inform him about side effects. The development of materials, instruments and surgical techniques has enabled the further development of apicoectomy. The introduction of magnifiers, endoscopes and microscopes into dentistry enabled more precise work. The use of bioactive retrograde materials in combination with microscopes has enabled minimal invasiveness with a predictability of success of over 90%.