The purpose of the present cross-sectional pilot study was to evaluate the influence of the quality of root canal fillings and coronal restorations on the periradicular status of these teeth. Seventy adult patients attended the Conservative dentistry clinic (Faculty of Dentistry, University of Khartoum), seeking routine dental care (not emergency care) were included. Patients were examined and the coronal restoration status was scored according to a modification of Ryge’s criteria for marginal adaptation. The quality of the root filling was assessed radiographically for length and homogeneity. The periapical status was categorized on the basis of presence or absence of signs of apical periodontitis (AP). The relationship between coronal status, quality of root filling and periapical health was determined statistically using Χ2 test. Thirtyfour teeth (48.57%) showed signs of AP. The combination of adequate coronal restoration and adequate root filling resulted in significantly reduced incidence of apical periodontist of 12.5% compared to 76.47% presence of AP when both parameters scored as inadequate. There was statistically significant relation between the quality of the treatment and the periapical status (p = 0.001). The incidence of AP in root-filled teeth was high. The importance of a good coronal restoration and an adequate root filling should be stressed as they both influence the periapical health.