Aim: Correlate signs and clinical symptoms with the healing process of the periapical tissue, after 12 months of microsurgical procedure, using (CBCT) cone-beam computed tomography images. Methodology: Observational, descriptive and prospective study, with a 12 month tracing using convenience sample in patients from the Graduate Endodontics Clinic, Faculty of Dentistry, Universidad Nacional de Colombia, whom during 2012 received apical microsurgery as a prescribed treatment. Samples included 25 teeth in 22 patients. The results of the healing process were tomographically evaluated comparing the size of the apical root injury pre and post-surgery, additionally a correlation of the tomographical findings with the signs and symptoms in every evaluated patient was made. For the statistical analysis, the results were grouped inside the periapical index PAI CBCT, apical root injury perimeter and the presence or absence of sign and symptom. The associations of the variables answering the healing process were analyzed individually and adjusted using a multiple linear regression model. Results: The healing percentage was 92% (complete/incomplete) and a failure percentage of 8% (unsatisfactory). The multivariate analysis demonstrated a positive association between the presence or absence of clinical symptomatology (signs/symptoms) at the moment of the revaluation at the 12 months and the decrease or increase of the apical root injury perimeter (p<0.05). Conclusions: The clinical sign, positive vertical percussion is directly related with the apical healing evolution process 12 months after the postsurgical evaluation. KEYWORDS: endodontic microsurgery, periapical periodontitis, prognostic, treatment outcome, cone-beam computed tomography, signs and symptoms.