In root canal therapy, complications frequently arise as a result of root fracture or imperfect cleaning of fins and invaginations. To date, there is no imaging method for nondestructive in vivo evaluation of the condition of the root canal, during or after treatment. There is a clinical need for a technique to detect defects before they give rise to complications. In this study we evaluate the ability of optical coherence tomography (OCT) to image root canal walls, and its capacity to identify complicating factors in root canal treatment. While the potential of OCT to identify caries has been explored before, endodontic imaging has not been reported. We imaged extracted lower front teeth after endodontic preparation and correlated these images to histological sections. A 3D OCT pullback scan was made with an endoscopic rotating optical fiber probe inside the root canal. All oval canals, uncleaned fins, risk zones, and one perforation that were detected by histology were also imaged by OCT. As an example of an area where OCT has clinical potential, we present a study of vertical root fracture identification with OCT.