Preserving the health of the dental pulp, or part of it, is important when treating a vital tooth with an exposed pulp; particularly, if the tooth is immature and root formation is incomplete. There is a long tradition of treating the exposed dental pulp by pulp capping. An improved understanding of pulp biology, the development of mineral trioxide aggregate and the advent of regenerative therapies have heralded a new wave of research and treatment methods in this area. The intention of this review is to evaluate the past, present and future of vital pulp treatment in endodontics. Keywords: calcium hydroxide, mineral trioxide aggregate, pulp capping, pulpotomy