Introduction : In some case of large periapical lesion of necrose teeth, it cannot be treated only with conventional endodontic therapy, but must requiring endosurgery intervention, such as apicoectomy. Apicoectomy performed to treat the periapical lesion, and will be followed with retrograde filling using mineral trioxide aggregate (MTA) to completed the treatment. Case Presentation : A 26 years old female patient reported to conservative departement with chief complained of pain and reccurent abses of centralis incisivus for years. Clinically , the tooth was hypersensitive to percussion and palpation but failed to respond to pulp sensitivity testing. Radiograph examination showed a large diffused radiolusence in apical insicivus centralis. The conventional endodontic treatment was performed on tooth #11, followed by apicoectomy with retrograde filling using MTA. Conclusion : The clinical and radiograph followed up for 4 months showed succesful result due to absence of abses and painful symptom and due to periapical bone repair. It was showed the effectiveness of apicoectomy and retrograde filling using MTA for the treatment of large periapical lesion of necrose teeth.