Hemisection and root resection are two surgical techniques employed in dentistry to address specific dental pathologies while aiming to preserve the natural dentition. Hemisection involves the removal of one-half of a multi-rooted tooth, typically necessitated by conditions such as severe periodontal disease affecting only one root or extensive decay confined to a specific root. Conversely, root resection entails the surgical removal of one or more roots of a multi-rooted tooth while conserving the remaining healthy roots, often indicated in cases of persistent infection or damage to a specific root. Both procedures are considered conservative alternatives to tooth extraction, offering the advantage of retaining natural tooth structure and function. Successful outcomes depend on careful patient selection, precise surgical technique, and appropriate postoperative care. Understanding the indications, limitations, and potential complications associated with hemisection and root resection is crucial for dental practitioners to effectively manage complex dental pathologies while striving to preserve the integrity of the dentition.