Purpose: A critical review of the literature on the periodontal considerations in removable partial denture (RPD) treatment is presented. Materials and Methods: A MEDLINE search was conducted for studies pertaining to the effects of RPDs on the periodontal tissues during the various phases of prosthetic treatment. The review included both in vivo and in vitro studies. Results: The use of RPDs leads to detrimental qualitative and quantitative changes in plaque. There seems to be a lack of information regarding the effects of RPDs on the status of periodontally compromised abutments. A number of studies, mainly in vitro, have failed to agree on the ideal RPD design. Clinical trials have shown that if basic principles of RPD design are followed (rigid major connectors, simple design, proper base adaptation), periodontal health of the remaining dentition can be maintained. Conclusion: Removable partial dentures do not cause any adverse periodontal reactions, provided that preprosthetic periodontal health has been established and maintained with meticulous oral hygiene. Frequent hygiene recalls and prosthetic maintenance are essential tools to achieve a good long-term prognosis. More prospective clinical trials are needed on the effect of RPDs on the condition of periodontally involved abutment teeth.