Endodontic pharmacology constitutes a fundamental pillar in modern dental practice, integrating pharmacological principles with clinical endodontics to achieve optimal patient outcomes. The primary objectives include pain control, elimination of microbial infection, and facilitation of periapical healing. Advances in pharmacology, microbiology, and biomaterials have significantly improved treatment success; however, challenges such as antibiotic resistance, opioid misuse, and management of medically compromised patients demand a rational and evidence-based approach. This review comprehensively discusses pharmacological agents used in endodontics, their mechanisms, clinical applications, and recent trends, while emphasizing safe prescribing practices and patient-centered care.[1]