Due to the biologic nature of endodontic diseases, the complex anatomy of the root canal, and the shortcomings and limitations of currently available instruments and materials for root canal treatment, the occurrence of problems is an immanent part of root canal treatment and consequently anticipation, prevention and management of such problems should be part of any treatment concept. The following paper tries to identify several major problems during root canal treatment and suggests a problembased treatment approach in order to prevent the occurrence of such problems. Beginning with diagnosis, differential therapy, estimation of degree of case difficulty, preparation of the access cavity and management of intracanal problems, a number of clinically relevant topics will be addressed. The aim of the following review is to convince the reader to accept such problems as a part of daily endodontic treatment; to anticipate possible problems as a part of the treatment planning; and to include prevention and management of problems in the routine concept for each root canal treatment. Schlagwörter: management, prevention, problems, root canal treatment