Background Coronavirus disease-19 (COVID-19) is a recent pandemic that is advancing at a rapid rate. The future course of the disease includes severe respiratory infection and also leads to death if unattended. Meticulous measures are necessary before attending any patient. The dental operatories and the clinic surroundings must be well sanitized so as to prevent the spread of pandemic. Aim and objective This review discusses in brief about the pathophysiology and course of COVID-19. Further, we discussed in detail the management aspects of patients in periodontal perspective and the sanitization procedures required for the dental clinic. Review results The SARS coronavirus enters the human circulation via the angiotensin-converting enzyme (ACE) receptors which are also found on the oral mucosal surfaces. Furin and Cathepsin L are the pro-inflammatory molecules released during pathogenesis of periodontitis and mediate the molecular pathways that help the virus invade into the host. The clinic set-up should be modified to best suit the pandemic conditions. This includes the three phases, i.e., phase I: preparatory phase; phase II: implementation phase; and phase III: follow-up. The patient management is explained based on the emergency needs of the patient based on the recent AAP classification of periodontal diseases and conditions 2017 as emergency, urgent, and elective treatment needs which have been explained in detail. Conclusion It can be strongly concluded that there is direct relationship between oral health and systemic health. The treatment procedures and sanitization protocols must be definitely modified. Further consensus and systematic reviews help us arriving at a more standardized protocol. Clinical significance This review would help clinicians modify the way they treat patients in the clinic and provide better services depending upon the emergency needs of the patient. How to cite this article Jafer MA, Hazazi MA, Mashi MH, et al. COVID-19 and Periodontitis: A Reality to Live with. J Contemp Dent Pract 2020;21(12):1398–1403.