Objective The aim of this study was to examine the levels of prostaglandin E2in periapical exudates before and after root canal treatment.Methods Periapical exudates specimens were quantitatively sampled from root canals of 25 teeth at con- secutive treatment visits, and the concentration of prostaglandin E2in each sample was determined using a commercial kit.Results The mean prostaglandin E2levels significantly decreased after the endodontic therapy. Significant correlations between the levels of prostaglandin E2and the clinical features of periapical periodontitis were also found in this study.Conclusion The results suggest that the level of prostaglandin E2in periapical exudates reflects the state of periapical periodontitis.