The restoration of endodontically treated teeth remains a challenge. The success of the final restoration depends mostly on the structure of the remaining tooth. Although the materials and procedures available today result in successful restoration of root-filled teeth via direct (in situ) techniques, one should first consider the amount of the coronal tooth structure remaining as well as the functional requirements. Restoration using direct composite resin is a good treatment option, but polymerization shrinkage is one of the major limitations of this material. The application of various base materials under the composite resin is an effective method. Covering the cusps with the restorative material is another option to save the remaining tooth structure; however, some materials may be unsuitable in stress-bearing areas. Materials applied to the orifice of a root canal also have a major effect on tooth biomechanics. This article reviews the direct restoration of endodontically treated teeth and discusses the current materials and techniques used for this purpose.