In every clinical situation there are a wide variety of treatment options that can be undertaken. As practitioners we owe our patients to be able to provide a wide range of treatment options based on, the clinical situation, age, economical considerations of the patient, and the best available clinical evidence of successful treatment modality. Patients are also becoming more educated in the available dental treatments and demands for conservative approach. This paper offers the treatment approach that preserves tooth structure in cases that are carefully selected. The molar tooth with extensive decay affected by endo-perio combined disease threatens the loss of the tooth. Hemi-section of the effected tooth allows the preservation of tooth structure, alveolar bone and cost savings (time and money) over other treatment options. In the right situation a fine restorative result can easily be attained using the root-section option.