Photodynamic therapy is a novel therapeutic approach for eradicating pathogenic bacteria in periodontal disease. Inactivation of microorganisms using photodynamic therapy has been defined as either antimicrobial photodynamic therapy (aPDT), photodynamic antimicrobial chemotherapy (PACT) or photodynamic disinfection. The use of aPDT requires a non-toxic photosensitizer, harmless visible light and oxygen. The photosensitizer binds to targeted bacteria and then can be activated by light of the appropriate wavelength in the presence of oxygen. Photoinactivation of bacteria is tightly restricted to the localization of the photosensitizer, ensuring the protection of distant cells from side-effects. Because of the fact that conventional treatment such as scaling and root planing (SRP) does not completely eliminate periodontal pathogens, especially in deep periodontal pockets, aPDT may be considered to be an alternative therapeutic strategy. This article describes the mechanism of aPDT and novel approaches such as nanoparticles. The aim of the study was to review the literature concerning the assessment of the effectiveness of aPDT in periodontitis treatment. Although studies have not indicated the superiority of aPDT compared to conventional periodontitis treatment, antimicrobial photodynamic treatment has been reported to be effective as an adjunct to conventional therapy to destroy bacteria in sites where there is limited access for mechanical instrumentation.