For many years, the connection between endodontic and periodontal disorders has been the focus of conjecture, misunderstanding, and debate. More than 50% of nonvitality of teeth today are caused by pulpal and periodontal issues. A pathogenesis for an endo perio lesion can range from being pretty basic to being fairly complex. When it comes to diagnosing and predicting the prognosis of the afflicted teeth, these lesions frequently cause difficulties for the doctor. Making the right diagnosis is crucial for determining the best course of treatment. The doctor should have a good awareness and scientific knowledge of these lesions in order to provide an accurate diagnosis. To treat these lesions, restorative, endoontic, or periodontal therapy may be required, either separately or in combination. In order to get the best results, this presentation will highlight the diagnostic, clinical guidelines, and decision-making processes in the treatment of these lesions from an endodontist's perspective.