Background: Bacterial infection of the dental pulp may lead to periapical lesions. They are generally diagnosed either during routine dental radiographic examination or following acute pain in a tooth. Various studies have reported a success rate of up to 85% after endodontic treatment of teeth with periapical lesions. Aim of the study: To study assessment of periapical radiolucency in teeth treated with periapical surgery. Materials and methods: The present study was conducted in the Department of Conservative Dentistry and Endodontics of the institution. For the study, we reviewed the records of patients who underwent peri-apical surgery between 2018-2019 at the Department of Endodontics. An informed written consent was obtained from the individuals whose records were reviewed. The records of the patients included initial clinical examination, chief complaint and initial symptoms, pre-operative and post-operative radiographs, summary of treatment provided and history of patients. The records and radiographs were analysed visually by 2 oral surgeons and 2 endodontists. A periapical lesion was considered as radiolucency of more than 1 mm. For the lesions with diameter > 5 mm, they were labelled as large lesions. Results: We observed that the number of maxillary anterior teeth was 12, maxillary premolar teeth was 5, and number of molars was 2. Similarly, the number of mandibular anterior teeth was 8 and mandibular premolars were 3 in number. We observed that no radiolucency was seen in 16 patients, radiolucency <5 mm was seen in 8 patients, radiolucency >5 mm was seen in 4 patients and radiolucency >10 mm was seen in 2 patients. Conclusion: Within the limitations of the present study, it can be concluded that periapical surgery is fairly successful approach for the management of periapical lesions which cannot be approached through conventional methods. Further studies are required in this context. Keywords: Periapical surgery, root canal treatment, periapical radiolucency.