Endodontic microsurgery has become a reliable technique with predictable outcome. Soft tissue management is an essential step in getting access to the periradicular area. Different techniques of incision and multiple flap designs have been described. It is sometimes difficult for the practitioner to find his way around all this information. This presentation will address new concepts of incision techniques such as the crossed incision technique. The criteria of choices for proper flap designs will also be covered.