Complete caries excavation was traditionally regarded as a basic precondition for successful restorative treatment. New results from clinical studies and a better understanding of the disease have led in recent years to a paradigm change in the treatment of caries lesions. Studies confirm that, in the case of deep caries, selectively leaving carious dentin in the vicinity of the pulp leads to less pulp exposure and fewer postoperative complications. On the other hand, fears of caries progression due to persisting bacteria were not confirmed on account of the tight sealant effect of the restoration. The following article presents different strategies for caries excavation, showing and assessing their advantages and disadvantages on the basis of recent scientific findings.