Abstract: Apicoectomy is a common clinical approach for managing post-treatment endodontic diseases and is primarily indicated for cases in which root canal retreatment is not feasible or has failed despite adequate retreatment. As the demand for apicoectomy increases in clinical practice, some endodontists may have an inadequate understanding of its indications or fail to follow standardized procedures, which may result in apicoectomy being performed on patients who could otherwise have been managed successfully with nonsurgical retreatment. Accurate selection of appropriate indications for apicoectomy is essential to the better preservation of the morphology and function of natural tooth roots and warrants careful consideration in both treatment planning and clinical implementation. This expert consensus provides standardized recommendations regarding the effects of apicoectomy on tooth function, clinical decision-making, and case selection for apicoectomy. It provides an objective reference for the clinical apicoectomy, thereby facilitating the preservation of the function of teeth affected by post-treatment endodontic diseases and improving long-term treatment outcomes.