Root resection and hemisection is a well-documented treatment option for extending the life span of furcated molars. The aim of the present study was to retrospectively evaluate the long-term results of root resection and hemisection of 195 patients with up to 40 years of follow-up. Records of 195 patients who had undergone root resection or hemisection were reviewed. A minimum follow-up of 5 years was needed. A molar was recorded as a survival if it was still present and functional without any signs of discomfort, pain, or pathology from restorative, endodontic, and periodontal points of view. Ninety-eight patients were excluded for not accomplishing the minimum 5-year observation period. Of the 97 remaining patients, 5 teeth were lost during the first 5 years of treatment and 92 teeth survived the follow-up period, ranging from 5 to 40 years. The overall survival rate was 94.8%. When up to 40 years of follow-up data were analyzed, it was found that high survival rates can be obtained with root resection and hemisection. The results are satisfying when a proper case selection, endodontic treatment, restorative design, and good maintenance program are given. This treatment option should always be considered before every extraction and implant placement.