To be able to determine if endodontic treatment of apical pathosis is successful or not, healing of lesions is followed up by radiographic imaging. This can be done by observing changes in apical radiolucencies. Recently, cone beam computed tomography (CBCT) has been introduced as a method of gaining an unabridged view of dental anatomy, thus eliminating some of the most prevalent problems, such as superimposition and distortion. CBCT reduces false diagnosis and is rapidly replacing other radiographic techniques in diagnosis, quality control of treatment methods and techniques, and outcome assessment. Healing assessment using conventional and newer three-dimensional imaging includes, but is not limited to, periapical osseous lesions, conditions of the maxillary sinus, status after endodontic surgery, hard tissue deposition in regeneration procedures, and horizontal root fractures. Due to a low predictive value of two-dimensional periapical radiographs to distinguish between periapical disease and health, future assessment of endodontic treatment efficacy may include 3D imaging from small field-of-view CBCT units.