The vitality of dental pulp is essential for long-term tooth survival. The aim of vital pulp therapy is to preserve vital, healthy pulp tissue. This therapy's foundation is the elimination of bacteria from the dentin-pulp complex. The treatment option depends on the cause and extent of mineralised tooth tissue destruction. The outcome of such treatment is determined by accurate assessment of the pulp's status and the dentist's ability to predict the success of the therapy. The aim of this review is to facilitate the dentist in making a proper decision referring to vital pulp therapy in permanent teeth, and to provide an overview of new approaches in such treatment.