The piezosurgery device is a new developed surgical equipment, which used piezoelectric ultrasonic vibrations to cut bone atraumatically and to provide an alternative to the mechanical and electrical instruments used in conventional oral surgery. It has been widely used in oral sugery, such as maxillofacial surgery, maxillary sinus lifting and periodontal surgery, et al. Recently, piezoelectric instruments can be applied in endodontic surgery, reducing the risk of damage to soft tissue, providing a clear operative filed, and cutting without generating heat. This review summarizes the operating principles of piezosurgery device and outlines the applications of pizeosurgery in endodontic surgery.