Pit and fissure sealants represent a pivotal preventive measure in contemporary dentistry, aiming to mitigate the risk of dental caries in susceptible populations. This study provides a comprehensive evaluation of the clinical application and performance of pit and fissure sealants, focusing on their efficacy, durability, and potential complications. A systematic review of literature was conducted, encompassing studies published between 2010 and 2024, to assess the clinical outcomes associated with pit and fissure sealants. Various databases including PubMed, Scopus, and Cochrane Library were searched utilizing specific keywords related to sealant application and performance. Inclusion criteria comprised randomized controlled trials, prospective cohort studies, and systematic reviews, while exclusion criteria encompassed case reports and studies lacking relevant clinical data.