Periodontal pocket depths and attachment loss are charted early in treatment to establish a benchmark against which the success of treatment regimens will be measured. They are considered both a measure of past inflammatory disease and a reservoir for periodontal pathogens capable of further destruction. The clinician must strive to identify predictable means of treating pockets. Three nonpharmaceutical approaches can be considered: maintain the present depth and hope for the best when treating a patient who has already demonstrated susceptibility; reduce the pocket by resective treatment, a frequently used and very predictable corrective methodology; reduce the probing depth by accomplishing periodontal regeneration. This last approach is the treatment of choice, but it is often impossible to achieve. This article describes a treatment regimen that recognizes the need for proper diagnosis and an initial nonsurgical debridement regimen before considering surgery. It then evaluates surgical treatment alternatives and concludes with a mandate for a well-constructed periodontal maintenance program. It also provides long-term detailed analysis of patient treatment.