Endodontic-periodontal combined lesion is a clinical dilemma because establishing a differential diagnosis and predicting a prognosis are difficult. A correct diagnosis is sometimes difficult; an accurate knowledge of the etiologic factors is essential for adequate choice of treatment. The management of endodontic-periodontal combined lesion demands both endodontic and periodontal therapy. Root resection therapy is one treatment option for preserving multirooted tooth with furcation involvement. This case report reviews root resective therapy and the concomitant endodontic management as a treatment option for an endo-periodontal lesion in periodontitis patients in maxillary molar. The role of root resection and treatment strategy are also discussed based on a review of the endodontic and periodontal literature.