Periodontal microsurgery was originally developed in reconstructive gingival surgery for treating gingival recession. It has been proven to be an effective means of improving the predictability of gingival transplantation procedure. Recently, the microsurgery has been placed an important role in endodontic diagnosis and treatment, especially in endodontic surgery. This microsurgical principles and techniques are going to be extended to flap surgery and suturing due to its advantages of precise wound control and atraumatic procedure by stretching, distorting, or tearing it. Periodontal microsurgery is an area of great interest and practical application in the future of periodontics.