Inadvertent extrusion of sodium hypochlorite toward the periapical tissues is an infrequent, yet alarming complication during root canal treatment. Such accidents seem to occur more often in female patients and during the treatment of maxillary teeth. Authors of case reports have proposed a number of possible causes for these accidents but corroborating evidence is usually lacking, so their aetiology is still a matter of debate. Various theories have been suggested to explain their occurrence and provide guidelines for clinicians in order to prevent them. Their management has been extensively discussed in the literature and appears more straightforward. This review aimed to present a critical analysis of the evidence on sodium hypochlorite accidents, highlight potential knowledge gaps and provide directions for future case reports and experimental studies. Keywords: accident, apical pressure, compliance, extrusion, sodium hypochlorite