This paper reviews periapical surgery with a special focus on the root-end cavity, which remains a key feature of the apicectomy procedure. Contemporary techniques mainly use ultrasonic instruments to prepare these cavities, which are filled with recently introduced materials. A review of the literature was undertaken using the PubMed database with the following terms: endodontic surgery, apicectomy, root-end cavity, and retrograde cavity. A manual search using references from this source followed. Contemporary endodontic textbooks were also reviewed, and a historic perspective was gained from a number of older books and references. Keywords: apicectomy, endodontics, periapical surgery, root-end cavity