The principle of ferrule effect is of prime importance when restoring an endodontically treated tooth. A severely broken down tooth due to subgingival caries almost always end up with extraction as inadequate ferrule effect would compromise the predictability of restorative treatment. This clinical case report describes a treatment approach that combines non-surgical endodontic treatment, orthodontic extrusion and prosthetic rehabilitation to restore the function and aesthetic aspect of an extensively carious premolar with compromised prognosis. One year follow-up indicated stable periodontal health with evidence of periapical healing radiographically.