Background:Pulpal infection has the potential to discharge through the periodontal ligament space, simulating periodontal damage. The current study was undertaken to compare two treatment approaches for Endo-Perio lesions.Methods:The research took place in the Endodontics department and involved 104 cases of Endo-Perio lesions, encompassing both genders. The participants were divided into two groups of 52 each. Group I received root canal treatment exclusively, whereas Group II underwent root canal treatment in conjunction with periodontal flap surgery. Various parameters, including the gingival index, plaque index, gingival bleeding index, probing depth, and radiographic bone level, were assessed at intervals of 0-1 month and 1-4 months.Results:In Group I, the mean gingival index was 0.40 mm, compared to 0.46 mm in Group II. The plaque index in Group I was 0.45 mm, while in Group II, it measured 0.38 mm. Group I had a gingival bleeding index of 19.2 mm, whereas Group II had 27.4 mm. The probing depth was 2.3 mm in Group I and 1.4 mm in Group II. The radiographic bone level was 2.2 mm in Group I and 1.5 mm in Group II. Conclusion:Both treatment approaches demonstrated a noteworthy improvement in the reduction of probing depth and attachment level postoperatively.