Objective: This study aims to evaluate the outcomes and considerations involved in the management of third molars, comparing endodontic treatment versus extraction. The study investigates factors influencing treatment choice, success rates, and associated complications to provide a comprehensive analysis of each approach. Methods: A retrospective analysis was conducted on 50 third molars treated at a single dental practice. Data on patient demographics, treatment types, reasons for treatment, and outcomes were collected. Endodontic treatments were assessed for success rates and complications, while extraction cases were reviewed for healing and any associated issues. Factors such as age, tooth location, and anatomical challenges were considered in treatment decisions.