Objective To study the surgical effect of periodontal pulp combined therapy on severe periodontitis and the prognosis of surgery. Methods The study subjects selected 60 patients with severe periodontitis admitted to our hospital from December 2016 to March 2018 (60 teeth), and were randomly divided into observation group (30 cases) and control group (30 cases). The observation group received periodontal treatment with periodontal pulp and the control group received periodontal treatment alone. The total effective rate of treatment and the recurrence rate and the aesthetic satisfaction of the patients were compared between the two groups, and the clinical indicators before and after treatment were compared. Results The total effective rate (93.33%) and recurrence rate (3.33%) of the observation group were not different from the control group [(80.00%), (10.00%)] [(P=0.13, χ²=2.31), (P =0.30, χ²=1.07)], aesthetic satisfaction (96.67%) was higher than the control group (73.33) (P=0.01,χ2=6.41); after one month of treatment, in the PD, AL, looseness of the observation group, there was no difference between the level and the control group (P>0.05), and the sulcus bleeding index (SBI) was lower than that of the control group (P<0.05). After three months of treatment, the AL, SBI and looseness of the observation group were lower than those of the control group (P<0.05). P<0.05), the PD level was not different from the control groups (P>0.05). Conclusion The combined of periodontal and endodontic treatment may be effective to patients with severe periodontitis, improve the clinical symptoms of patients, and increase the aesthetic satisfaction of patients, which is worthy of clinical promotion.