Endocrowns have emerged as a conservative and effective restorative option in endodontically treated teeth, particularly for posterior teeth with significant structural loss. This review aims to provide a comprehensive overview of endocrowns, highlighting their design principles, material choices, biomechanical advantages, clinical indications, and long-term performance. Compared to traditional post-and-core systems, endocrowns offer a minimally invasive approach by utilizing the pulp chamber for macromechanical retention and adhesive bonding for micromechanical stability. Advances in adhesive dentistry and CAD/CAM technologies have further enhanced their clinical applicability and success rates. The review also discusses current evidence regarding marginal adaptation, fracture resistance, and failure modes of endocrowns in comparison to conventional crowns. Despite some limitations, endocrowns represent a promising treatment modality that aligns with modern restorative philosophies focused on tissue preservation and functional longevity.