Objective: To observe the curative effect of non-surgical treatment under periodontal endoscope in the patients with moderate-to-severe periodontal pockets of multirooted teeth after scaling and root planning (SRP), and to expound the clinical significance of periodontal endoscope in assisting periodontal non-surgical treatment. Methods: After SRP, there were still more than 127 multirooted teeth with moderate-to-severe periodontal pockets in 24 patients with periodontitis. The above multirooted teeth received non-surgical treatment under periodontal endoscope, the control of periodontal risk factors was evaluated by the periodontal risk assessment (PRA) model; the probing depth (PD), bleeding on probing (BOP), attachment loss (AL), calculus residual rate of the patients after treatment were detected by Florida Probe system; the percentage of furcation defect was detected. Results: After 3 months of periodontal endoscope-assisted periodontal non-surgical treatment, the risk factors of the patients after treatment were reduced and the patients had good prognosis. The PD value and percentage of BOP positive sites of the teeth of the patients after treatment were significantly decreased compared with before treatment (P< 0. 01); the PD value of the near-distal median point was obviously decreased compared with the PD value of the central site (P< 0. 01); the positive rate of calculus was significantly decreased (P<0. 01); there was no significant difference in the AL (P>0. 05). The percentage of teeth with Class I furcation involvement among the multirooted teeth after treatment was significantly lower than before treatment (P<0. 05), but the percentage of teeth with Class II and above furcation involvement had no significantly difference between before and after treatment (P> 0. 05). Conclusion: The effect of periodontal endoscope-assisted non-surgical treatment for the multirooted teeth with residual moderate-to-sever periodontal pockets after SRP, and it can avoid periodontal operation to some extent.