Objective: The purpose of this study was to determine the current trends in usage, handling and dispensation of endodontic files by the dental practitioners of Karachi. Methodology: In this cross sectional study, two hundred and seventy survey performas were distributed to the dental teaching institutes and private dental clinics of Karachi. Survey participants were questioned about the preferred type of endodontic therapy, file system, method of dispensation of files, method of disinfection or sterilization of used files, criteria to discard used endodontic files and the preferred method of removal of debris from used files. SPSS version 21 was used for the calculation of frequency and percentage for statistical analysis. Results: Total two hundred and seventy survey forms were distributed out of which 200 were received with total response rate of 70.07%. 45.5% of dental practitioners perform manual root canal where as 19.5% prefer rotary endodontics. 82.25% respondents preferred to use Protaper files for rotary endodontics. 69.5% of the participants dipped the files in hydrogen peroxide while 20% kept their files in sodium hypochlorite while performing endodontic therapy. Autoclaving of the used files was found to be most common method amongst 87.5% of the participants and 80% of the respondents discard the files on first sign of deformation. 53% of the respondents dipped files in hydrogen peroxide to remove debris after usage.