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Background: An ideal endodontic repair material is the one that not only seal the pathways of communication between the root canal system and its surrounding tissues but in addition, should be nontoxic, noncarcinogenic, nongenotoxic, biocompatible, insoluble in tissue ﬂuids and dimensionally stable. Because existing materials did not have these ‘‘ideal’’ characteristics, mineral trioxide aggregate (MTA) was developed and recommended. MTA has been proposed as the material of choice for root-end ﬁlling, pulp capping, pulpotomy agent, apical barrier formation for teeth with necrotic pulp and open apex, perforation repair and apexiﬁcation. Numerous clinical investigations have been performed evaluating MTA for each one of the above mentioned applications and have found it to be an efficient material. This paper presents a case series of five different clinical conditions involving use of MTA for its successful management. Materials and Methods: This paper describes the efficacy of MTA in various clinical condition. Four case reports have been described, in case 1 MTA was used for apexification in anterior teeth, in case 2 MTA has been used to form a barrier in horizontal root fracture, in case 3 it was used as a retrograde sealing material after apicoectomy, in case 4 MTA was used in posterior tooth for apexification. The powder was mixed with saline in a ratio of 3:1, after placing it in the desired place a wet cotton pellet was placed for a time period of 24 hours. After the MTA was set further treatment was carried out. All the cases showed successful healing both radiographically and clinically. Conclusion: MTA materials are very positive, existing information as a whole are equivocal and more studies are encouraged. The use of MTA changed dramatically the treatment plan and increased the success rate of many previously thought of as hopeless cases. MTA is an efficient and promising dental material that should be used routinely in the practice of pediatric endodontics.