Endodontic surgery has been reported to have a desirable radiographic and clinical outcome, due to the recent advances in technology, magnification, and materials. However, the esthetic outcome of the procedure has not been fully explored, and sometimes, even neglected. In this lecture, we define success as a tridimensional desirable outcome: radiographically, clinically, and esthetically. The speaker will first define optimal and sub-optimal esthetics outcomes. Later on, he will talk about the pre-, intra-, and post-operative factors involved in the esthetic outcome. In the next part of the lecture, the speaker will discuss how the clinician can modify and alter these factors in order to achieve the highest level of esthetic outcome. In the last part of the lecture, advantages and limitations of different surgical techniques as it pertains to esthetic outcome will be discussed.