Endodontic surgery is commonly used for removing infected portions of the root apex that cannot be cleaned through non-surgical endodontic treatment, or also for retrograde filling. Non-surgical endodontic treatment is usually the first choice when treating endodontic failed cases, but in some conditions, we must consider endodontic surgery for a better outcome. There are many key factors affecting the success rate, and the evaluation of clinical conditions before treatment planning is important for achieving a better prognosis. In this article, a 69-year-old woman had previously received non-endodontic treatment but resulted in failure. Due to difficulty of removing her prosthesis, the surgical method of endodontic treatment was chosen. A one-year follow-up showed good results. Reasons of failure in non-surgical endodontic treatment will be discussed and also how surgical endodontic treatment will provide a better prognosis.