My presentation will focus on the clinical assessment that the dentist should be required to perform when deciding whether to pursue an endodontic retreatment or instead proceed directly with implant therapy. I deliberately use the conditional form because, unfortunately, in everyday practice the general dentist is increasingly inclined to prefer implant placement—driven both by economic considerations and by the relative procedural simplicity—rather than by the patient’s actual best interest. This trend risks undermining the remarkable advances achieved in recent years in the field of endodontics, largely due to the introduction and widespread use of the operating microscope. Endodontic retreatment—both surgical and non-surgical—is progressively becoming a niche procedure, carried out by a shrinking number of practitioners who uphold a deontologically sound, tooth-conserving approach. I believe that endodontic societies should concentrate their efforts on educational campaigns directed primarily toward patients rather than dentists. In my view, attempting to sensitize the general dentist to these issues, although valuable, is largely a losing battle. Educating patients, on the other hand, could foster a more informed demand for conservative treatment options. During my presentation, I will also aim to delineate the boundary between appropriate endodontic retreatment and true over-treatment. I will evaluate a series of parameters not only related to endodontic criteria but also to patient age, the quantity and quality of remaining dentinal structure, functional and occlusal factors, and other clinical considerations that may influence prognosis and guide clinicians toward a genuinely individualized therapeutic decision.