Cone Beam Computed Tomography (CBCT) has significantly transformed endodontic diagnosis and treatment planning by providing three-dimensional visualization of dental and surrounding anatomical structures. Conventional two-dimensional radiographs often present limitations due to image distortion, superimposition of structures, and inability to accurately assess complex root canal anatomy and periapical pathologies. CBCT offers superior diagnostic capabilities in the detection of root canal morphology, periapical lesions, root fractures, resorptive defects, traumatic injuries, and treatment complications. This review explores the principles of CBCT imaging, current applications in endodontic diagnosis, advantages, limitations, radiation considerations, and future developments. The study highlights the role of CBCT as a valuable adjunctive diagnostic tool that improves clinical decision-making, enhances treatment predictability, and contributes to better patient outcomes.