Aim: To treat cases of palato-radicular groove associated with localised periodontitis using conservative and/or regenerative approach based on the depth and extent of the groove. Objective: To utilise various regenerative approaches in the management of palato-radicular groove with associated periodontitis in order to enhance the regeneration of the lost periodontium. __ampersandsignnbsp;Case description: Three cases of unilateral PRG with localised periodontitis involving the maxillary lateral incisor in 2 cases and central incisor in 1 case has been discussed. The article showcases the result of conservative and /or regenerative approach used in the management of these cases. Bone graft, platelet rich fibrin and guided tissue regeneration using resorbable membrane has been used in the treatment depending on morphology and depth of intrabony defect. Conclusion: Thorough examination by the clinician helps in early detection of palato-radicular groove and prevents the loss of the periodontium. Palato-radicular groove associated with severe localised periodontitis can be successfully managed using various regenerative approaches.