The high success rate of apical surgery is attributed to the extensive use of oral microscope and ultrasonicinverted preparation equipment, as well as the good biocompatibility of the technique. Factors influencing the prognosis of microsurgical operation of the root tip must be elucidated to provide a reference for selecting clinical cases and developing accurate and effective treatment plans. In this paper, factors affecting the prognosis of patients who underwent apical microsurgery are reviewed based on three aspects: patient, teeth, and operation.