Pulp therapy aims to preserve and protect the inflamed pulp tissue from additional injury and facilitate its healing and repair while maintaining the health status of the tooth. With the advent of new biomaterials, the outcome of vital pulp therapy increased significantly with a high level of predictability. Contrarily, necrotic pulps with apical periodontitis present a clinical challenge, particularly in immature roots with short undeveloped root structures, thin dentinal walls, wide-open foramens and unpredictable disinfection, all of which will affect the long-term treatment outcome. MTA apexification remains a great treatment option for immature necrotic teeth, particularly for cases with advanced root development. Pulp revascularization exploits the full potential for tissue ingrowth toward dentin-like tissue deposition and stronger roots able to withstand fracture, mainly on teeth with poor maturation. This presentation will review the current evidence-based research for vital and non-vital therapy for the young permanent dentition and illustrate the importance of case selection to obtain positive outcome.