This review reveals the possibility of using the newest technology of cone beam CT for acquiring three-dimensional images of periapical lesions and, mandibular canal. It has a higher efficiency in X-ray use, inhent quickness in volumetric data aquisition, and potential for reducing the cost of CT. It requires only a single scan to capture the entire object with a cone of X-rays with reduced exposure time. The high quality and affordable cone beam CT is ideally suited for diagnosis, treatment planning and treatment monitoring in endodontics especially when surgical approach is chosen. Three dimensional anatomic and pathological observations improve the surgical performance.