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Current treatment options for immature permanent teeth with pulpal necrosis include both apexification and regenerative endodontics. The purpose of this study was to survey endodontists on the use of these 2 treatment options.Surveys were created by using Qualtrics and Teleform software and distributed by using the Salant and Dillman method. Endodontists (n = 1615) in 4 geographically and demographically diverse states, North Carolina, New York, Texas, and California, were surveyed. Data were analyzed by using descriptive statistics and χ2 analysis. Level of significance was set at 0.05.A 32.9% response rate was obtained. The majority of responders reported that apexification was the treatment of choice when considering the evidence base supporting the treatment (60%) and the predictability of treatment outcome (77.8%). Apexification was also the preferred treatment by 57.3% of respondents when asked to consider patient compliance, by 51.2% when considering the number of required patient appointments, and by 53.3% when considering the likelihood of tooth discoloration. Regenerative endodontics was reported as the preferred treatment by 89% of respondents when considering continued root development and by 66.7% when considering apical closure. The respondents’ age and continuing education courses taken were significantly associated with their preferred treatment option.The results of our study indicate that endodontists consider both clinical and patient factors when treating immature teeth with pulpal necrosis. Increase in continuing education options may increase adoption of regenerative endodontic therapy.