Cone-beam computed tomography (CBCT) has emerged as a revolutionary tool in endodontics, significantly enhancing diagnostic accuracy and treatment planning. This study aimed to evaluate the impact of CBCT in detecting periapical lesions, assessing complex root canal morphology, and identifying endodontic failures conducted at Bakhtawar Amin medical and dental college Multan. A total of 120 patients undergoing endodontic treatment were categorized into two groups: CBCT-assisted diagnosis (n=60) and conventional radiography (n=60). The results demonstrated that CBCT exhibited a 38% higher sensitivity in detecting periapical lesions than periapical radiographs (p<0.001). Additionally, root canal complexities, such as C-shaped canals and additional canals, were identified in 27% of cases using CBCT but missed in 14% of conventional radiographs. CBCT was particularly valuable in retreatment cases, where unidentified missed canals were found in 19% of previously treated cases. The discussion highlights how CBCT improves diagnostic precision, minimizes procedural errors, and aids in surgical planning for apical surgeries. Given its ability to enhance clinical decision-making, CBCT should be considered an essential adjunct in modern endodontic practice.