Background: Peri-implantitis constitutes one of the most frequent late dental implant complications. The disease is initiated by bacterial infection; therefore, anti-infective peri-implantitis treatment strategies are required to arrest the progressive marginal bone loss and maintain the affected implant in function. Although nonsurgical treatment strategies appear to be of limited predictability, treatment outcomes have been frequently improved following surgical interventions. Purpose: The present narrative review describes various surgical peri-implantitis treatment modalities, with respect to their indications, performance, and effectiveness. Materials and Methods: The present narrative review considered the most relevant studies in the field published in the English language. Results: Surgical peri-implantitis treatment approaches can be categorized as nonreconstrucive therapy, reconstructive therapy, and combined therapy (ie, reconstructive and resective therapy). In addition to disease resolution, reconstructive approaches also seek to regenerate the bone defect and achieve reosseointegration. Conclusions: The severity of the disease, the regenerative potential of the defetc and esthetic demands of the patient are the factors determining the surgical peri-implantitis treatment modality.