Tooth preparation is defined as the mechanical alteration of a defective, injured, or diseased tooth in order to best receive s restorative material which will re-establish a healthy state for the tooth including esthetic corrections where indicated along with normal form and function. Indications for restoration, Objectives of cavity preparation, Factors affecting cavity preparation and Conservation of tooth structure are explained at the outset of the chapter. Next the chapter discusses about the extension for prevention philosophy, enameloplasty and various non-carious pathologies affecting tooth structure. Then the chapter explains about tooth preparation terminologies, classification of tooth preparation. Then the chapter deals in length about the stages and steps in tooth preparation given by Dr. G.V. Black. The chapter concludes with explanation about biologic form of tooth preparation i.e., pulpal and periodontal considerations like biologic width preservation.