The efficacy of periodontal surgery in the treatment of periodontal diseases not yet been systematically evaluated. The objective of this review was to systematically evaluate the efficacy of periodontal surgical procedures in the various treatment modalities. Periodontal disease is multifaceted in nature and scope. The problems created due to this inflammatory condition are different eg. gingival enlargement, osseous deformities, mucogingival problem which ultimately may lead to tooth loss. There are different surgical treatment modalities to treat periodontitis and its clinical manifestation. There is no one way or single method to approach this inflammatory condition. The ultimate treatment selection is determined by training, ability, and philosophy to attain complete regeneration of the lost periodontal tissue.