This case report describes the management of endo-perio lesion. A 40 year old patient reported with pain and discolored tooth with history of road traffic accident a year ago. Intraoral examination of tooth 11 revealed the presence of restorative material and a sinus tract opening with probing depth of 6mm. Following full mouth scaling, access opening and biomechanical preparation was done during which intra-canal irrigant was seen oozing through the sulcus of tooth 11. Multiple RVGs were taken as there was difficulty in negotiating the canal which suggested the presence of communication. Surgical intervention was carried out were root perforation was noted. Canal was negotiated and perforation was repaired using biodentine. Collagen membrane was placed as a barrier. Patient was recalled after 2 weeks, 1 month and at 3months. At the end of three months there was complete reduction in probing depth with satisfactory soft tissue healing. Proper diagnosis of the endo-perio lesion is the key to success. The multidisciplinary approach with accurate diagnosis contributed to the favorable therapeutic outcome.