Root canal calcification is a difficult problem in the clinical treatment of endodontic periapical disease. The degree of root canal calcification varies and is often treated clinically by root canal therapy and surgical procedures. However, surgical procedures are more traumatic to the body, and the use of root canal microscopes and special ultrasonic instruments in the past 30 years has provided a proven method for the treatment of root canal calcification. For the treatment of calcified root canals, the clinician must have a thorough understanding of the calcified root canal of the affected tooth before treatment. The clinician should have a good command of all types of root canal preparation techniques, have good equipment, and be able to operate with care and patience. He should communicate fully with the patient before the procedure, inform him of the costs and complications, and involve him in the treatment planning.