Background: The restoration of endodontically treated teeth (ETT), particularly those with significant coronal loss, remains a clinical challenge. Traditionally, post-and-core-supported full coverage crowns were considered the gold standard. However, advancements in adhesive dentistry and restorative materials have led to a paradigm shift toward more conservative and biomimetic approaches, including endocrowns and overlays. This review aims to evaluate current evidence on restorative strategies for ETT, emphasizing adhesive, post-less options like endocrowns and overlays. It also highlights the biomechanical considerations, material advancements, and preparation designs that influence clinical outcomes. Methods: This narrative review was conducted by searching PubMed, Scopus, and Google Scholar for English-language articles up to June 2025. Keywords included: "endodontically treated teeth," "endocrowns," "overlays," "fiber-reinforced composites," "biomimetic restorations," and "fracture resistance." Eligible studies focused on mechanical behavior, clinical performance, material comparisons, and restoration design for ETT. Conclusion: Conservative adhesive restorations—especially endocrowns and overlays—offer viable alternatives to traditional post-core crowns in ETT, provided that case selection, isolation, and bonding protocols are meticulously followed. Biomimetic materials, such as fiber-reinforced composites and advanced ceramics, enhance stress distribution and contribute to favorable fracture patterns. Endocrowns are particularly effective for posterior teeth with sufficient pulp chamber depth. Despite encouraging outcomes, further clinical trials are needed to define optimal treatment strategies for compromised cases with minimal remaining tooth structure.