Objectives: The purpose of this article was to propose guidelines for dental practitioners facing the dilemma whether to treat, follow up, or disregard random asymptomatic radiographic findings. Data sources: Searches performed in MEDLINE, Cochrane, and EMBASE databases were followed by a manual search. Related data incorporated by experts included recommendations on asymptomatic root canal treatment, quality of the root canal, and restoration relative to outcome. Evidence tables were developed following quality and inclusion criteria assessment. Results: The initial search retrieved 2,796 MEDLINE, 542 EMBASE, and 152 Cochrane articles, for a total of 3,490 potential articles. After duplicates were removed, 2,946 articles remained. Articles not related to the topic and not meeting eligibility criteria were excluded, resulting in 44 studies included in this scoping review. Conclusions: The proposed guidelines provide easy access to existing information in endodontics. The findings are common and possess clinical and medico-legal importance. Keywords: asymptomatic periapical lesion, coronal restoration, endodontic success, follow-up, microleakage, outcome