Apical surgery is a safe alternative when teeth are not responding to conventional endodontic treatment and re–treatment. The main goal of apical surgery is to prevent bacterial leakage from the root canal system into the periradicular tissues by placing a root–end filling following root–end resection. The aim of this paper is to present a case involving the surgical managemenet of a cutaneous sinus tract indicated due to failure in conventional endodontic treatment. A cutaneous sinus tract of dental origin is a canal that drains the infection from a dental source to the neck or face. A misdiagnosis could lead to an ineffective or inappropriate treatment.