Abstract: The primary goals of treating pulpal and periapical diseases in young permanent teeth are to preserve vital pulp tissue to the greatest extent possible and promote continued root development. Given the relative paucity of high-level evidence in this field, the consensus development group systematically searched PubMed, the Cochrane Library, and the China National Knowledge Infrastructure (CNKI), and integrated the latest position statements from international academic organizations with the clinical experience of Chinese experts in the field. The expert consensus was developed using the nominal group technique. This consensus systematically outlines key considerations for the clinical assessment of pulpal and periapical status in young permanent teeth and specifies the selection criteria and procedural recommendations for pulp treatment modalities in different clinical scenarios. A stratified treatment strategy was developed based on the degree of pulpal inflammation, tissue vitality, and stage of root development according to the Nolla classification. A flowchart of the standardized diagnostic and treatment pathway and criteria for follow-up assessment of treatment outcomes were also established. This consensus aims to provide guidance for dental clinicians at all levels in the standardized diagnosis and treatment of pulpal and periapical diseases in young permanent teeth.