Background: Endodontic treatment is usually performed in teeth with periapical lesions. However, in some cases the pathology persists. Thus, periapical surgery has to be performed. It is considered to be the last treatment option before the extraction of a tooth. The main objective of periapical surgery is to seal the root canal system, thereby enabling healing by forming a barrier between the irritants within the confines of the affected root and the periapical tissue. Aim: To evaluate factors responsible for clinical outcome of periradicular surgery. Materials and method: The present study was conducted by combined effort of the department of conservative dentistry and endodontics and the department of oral surgery of the dental institute. For the study, Abstract we selected 25 patients scheduled for periradicular surgery. The surgical procedure was performed under local anesthesia. For the postoperative assessment, radiographs were done postoperatively. Analgesics were prescribed to the patients and sutures were removed after 4-7 days. Follow up was done at 6 to 12 months postoperatively and assessment of treatment success was done clinically and radiographically. The Cases with presence of pain, tenderness to percussion, tenderness to palpation of buccal mucosa, swelling of buccal mucosa were termed as clinical failures. The evaluation of case was also done radiographically. Results: We observed that 18 patients had preoperatively complaint of pain. The success rate of periradicular surgery in these patients is 86.7%. Similarly, significant difference was observed in preoperative clinical symptoms of tender to percussion, Presence of fistula, and resurgery cases. Conclusion: Within the limitations of current study, we conclude that tenderness on percussion, presence of fistula and resurgery cases are strongly associated with the success of periradicular surgery. Keywords: Periradicular Surgery, Endodontics, Resurgery, Peri-Apical Lesion