In this paper, the biological events that give rise to the radiographic appearance called calcific pulp obliteration will be described, as will the anatomical and histological changes that attend its presence. There will also be a review of the studies that explore the relative incidence of this pulp change subsequent to trauma, and the incidence of attending periapical disease that should indicate to the clinician that some form of treatment is required. Finally, the endodontic management of these teeth will be described with emphasis on the types of adjustments that can be made to minimize the chance for a procedural accident.