Background:Endodontic therapy, commonly known as root canal therapy, is a systematic treatment approach aimed at addressing the infected pulp of a tooth. The goal is to eliminate the infection and safeguard the decontaminated tooth against potential microbial invasions in the future. This study was conducted to evaluate the factors contributing to failures in endodontic procedures within the study groups.Methods:This study involved the examination of 224 patients, encompassing a total of 320 teeth that had undergone root canal treatment. The evaluation focused on determining the presence or absence of periapical radiolucency, the quality of obturation, the identification of missed canals, and the assessment of issues such as dislodged or fractured restorations. Additionally, potential iatrogenic problems, including perforations, file separations, and ledges, were scrutinized using intraoral periapical radiographs.Results:Among the 224 patients, there were 120 males and 104 females, with males having 170 teeth and females having 150 teeth. The primary cause of endodontic failure varied between genders. In males, the most common reason was a missed canal, accounting for 30%, followed by inadequate obturation at 25% and fractured coronal obturation at 45%. Conversely, females exhibited a higher prevalence of a missed canal at 40%, with inadequate obturation at 10% and fractured coronal obturation at 50%. Conclusion:The author identified missed canals, inadequate obturation, and fractured coronal obturation as prevalent causes of root canal failures.