Examination of lymphocytes from peripheral blood with the scanning electron microscope (SEM) has shown differences between B cells and T cells on the basis of their surface architecture. This study was initiated to determine whether the cellular components of periapical lesions could be identified with the use of similar criteria. Cells were dispersed from lesions by aspiration of fragments of tissue through syringe needles of decreasing diameters. The liberated cells were filtered on silver-coated Flotronic membranes and examined under the SEM. Lymphocytes, macrophages, epithelial cells, and mast cells were observed in granulomas and cysts. Most of the lymphocytes had smooth surfaces similar to that of T cells; others had villous projections similar to that of B cells. Epithelial nests were seen in the cyst linings while the cyst fluid was rich in lymphocytes. These findings suggest that SEM examination of periapical lesions can be a useful adjunct in studying cellular composition and possible immunological reactions in these tissues.