Vertical root fractures associated with endodontically treated teeth is one of the most difficult condition to diagnose and equally difficult to treat. The condition further complicates if any use of dowel is indicated. Prognosis is often hopeless and differential diagnosis from other pathosis may be difficult. Traditionally, this condition was managed by extraction of offending tooth but with advent of adhesive dentistry, there is a paradigm shift towards preservation of these teeth. This article focuses on the etiopathogenesis, diagnosis and management of vertical root fracture. Key words: Vertical root fracture, root fracture, endodontically treated tooth, cracked tooth