The need for ideal restorative material in terms of enhanced clinical performance and longevity is a primary requirement, and concern, in contemporary restorative practice. None of the available restorative materials provide with biomechanical properties similar to that of natural enamel and dentin. Therefore the concept of replacing missing or defective tooth structures with natural enamel or dentin termed as “Biological Restorations” has resurfaced. The current review provides an insight into clinical applications with evidence of success, advantages, limitations, ethical and biosecurity risk concerns regarding biological restorations and also makes an attempt to propose a definition and a classification system based on clinical implications.