Background. The clinical decision as to whether an endodontically treated (ET) tooth requires a post and a crown poses a challenge to dental practitioners. The author conducted a review of the principles for the use of post and core and the newer materials such as ceramic and fiber-reinforced posts. Types off Studies Reviewed. Using a MEDLINE search and resulting cross-references, the author selected original research articles and previous review articles on the topic of ET teeth, as well as that of post and core. Results. The author reviewed the principles for the use of posts in terms of when it is necessary to use a post, different types of posts, various post materials and designs. He also reviewed. the criteria and technique for post space preparation and post cementation. Finally, he discussed the principles of core buildup, as well as options for the final restorations. Clinical Implications. The author provides a review of the principles for the use of post and core, crowns and the different materials available today to help clinicians make a clinical decision based on sound evidence.