For deep carious lesions, there are different treatment modalities that aim to avoid exposing the pulp and, thus, in the long-term root canal treatment. Understanding the biological events in caries pathology will facilitate the choice of treatment and why selective caries removal treatments, in many cases, can be recommended. Before selecting any modality, it is advantageous to know the expected prognosis based on clinical studies. After treatment, the patient should be monitored for signs of pulp disease. Current practice differs between dentists, and this chapter aims to provide evidence-based and consensus recommendations for the treatment of deep carious lesions.