Conservative endodontic access cavities and conservative preparation of the root canals have been proclaimed as means to preserve sound dentin in critical areas of the tooth. Many clinicians believe this preservation facilitates the longevity of endodontically treated teeth (ETT). However, the conservative approach challenges some endodontic principles that have been taught for decades. Therefore, conservative endodontics has encountered resistance from endodontists who believe that the conservative approach could potentially hinder the ability to locate, disinfect and properly treat the canals. Recently, some studies have been published as an attempt to elucidate some of the clinical questions regarding conservative endodontics. Is this research able to translate the clinical reality? This presentation presents clinical cases and reviews the current literature surrounding contracted access and preparation of ETT, providing sound information to independently form educated decisions regarding the efficacy and application of conservative endodontics.