Minimum intervention and retention of every part of the tooth structure is an imperative objective in contemporary endodontic practice. Nevertheless, elective (intentional) root canal treatment (RCT) of sound teeth with normal pulps may be necessary. This article aims to define the criteria for considering RCT as an elective treatment, to discuss the indications of this approach and the prevalence among different countries, and to outline special precautions that should be considered when commencing elective RCT. In addition, other elective pulp treatment procedures are highlighted. Keywords: elective, intentional, prevalence, root canal treatment