A vertical root fracture is a longitudinal fracture of the root, most often in the buccolingual direction, possible on any part of the root. The fracture can be complete or incomplete. It was observed in both vital teeth and endodontically treated teeth. It is caused by the action of wedge forces that exceed the strength and elasticity of the dentin inside the root canal. The most common etiological factors are excessive forces during obturation, wedge effect of abutments and excessive removal of root dentin. It is one of the most difficult clinical problems to diagnose and treat. The diagnosis is often unreliable because vertical fractures mimic other conditions and clinical pictures such as periodontal disease or inadequate endodontic treatment. Subjective symptoms are often minimal; periapical process, periodontal abscess or tooth mobility may be present. There are four pathognomonic signs for establishing a diagnosis: bite sensitivity, a sinus tract in the middle or coronal third of the root, a deep narrow pocket without previous periodontal disease, and a radiological finding of bone resorption to the apex or resorption in the form of a droplet. The surest proof is the surgical presentation of the root. The therapeutic solution is the removal of the fractured root or the entire tooth, therefore a wrong diagnosis has serious consequences.