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This case series evaluated the long-term clinical outcome of nonvital immature teeth treated with mineral trioxide aggregate (MTA) as an apical barrier and an adhesive restoration with or without a fiber post. Eighty-three teeth in 72 patients were treated by the first author with an apical MTA plug and an adhesive restoration of composite resin and in 45 of the 83 teeth 1 or more fiber posts. All of the patients had been referred to the first author's private endodontic practice with at least 1 immature tooth with signs of pulpal necrosis and subsequent apical periodontitis that had been caused by a variety of traumatic dental injuries. Three teeth presented had dens invaginatus. Of 83 teeth, 69 teeth in 60 patients were available for follow-up after 5 to 15 years (recall rate = 83%). The mean follow-up time was 8.29 years. No teeth were lost because of a root fracture. Ninety-six percent (66/69) of the recalled teeth were characterized as healed. Based on periapical radiographs and clinical examination, 96% of teeth treated with the MTA barrier technique and adhesive restorations were characterized as “healed” and were in function after 5 to 15 years (mean = 8.29 years). These results indicate that this is a viable and predictable treatment approach for the long-term success of nonvital immature teeth.