Probiotic therapy in endodontics emerges as a promising biotherapeutic strategy to modulate the microbiota of the root canal system, prevent microbial recolonization, and promote pulp-periapical health. Probiotics, defined as live microorganisms that confer health benefits to the host, have demonstrated antimicrobial and immunomodulatory effects, in addition to competing for nutrients and adhesion sites against endodontic pathogens such as Enterococcus faecalis and Candida albicans. The reviewed evidence includes in vitro, in vivo, and clinical studies, highlighting the ability of strains such as Lacticaseibacillus rhamnosus, Limosilactobacillus reuteri, Lactiplantibacillus plantarum, Lacticaseibacillus casei, and Bifidobacterium species to inhibit pathogens in both planktonic and biofilm phases, with efficacy comparable to traditional irrigants and intracanal medication but with lower c...