Dentists must meet the increased demands of patients for esthetic dentistry. Because the substitution of amalgam with direct composite restorations is somewhat problematic and restricted to special indications only, the most suitable method is the esthetic inlay. All available systems are reviewed and described. These restorations must be inserted with adhesive techniques. The performance and the problems associated with these techniques are described in detail. Improvements in luting techniques, eg, the use of ultrasonic energy, may further simplify the application technique for esthetic inlays. For clinical success, the margin quality of adhesively luted inlays is essential. In vitro and in vivo studies with esthetic inlays report good clinical behavior of such restorations. However, until the results of long-term clinical studies are available, these systems should not be used on a routine basis as a substitute for amalgam.