Endodontic procedures are used to treat large periapical lesion. Additional apical surgery is performed in few cases. Various irrigating solutions like Chlorhexidine, Sodium hypochlorite are used. Some clinicians prefer Ca(OH)2 as intracanal medication. Non-surgical and surgical methods show no difference in long term follow up. Non-surgical endodontic treatment leads to complete resolution of periapical lesions and should be the treatment of choice.