Mechanisms of pulpal pathophysiology are complex and the low compliance environment in which the dental pulp is allocated, further enhances the complexity of this process. Although it is known that it involves the interaction of the immune cells, pulpal cells, cytokines, chemokines and multiple neuropeptides but still there are many gaps in our current knowledge. The understanding of the biochemical and molecular pathways involved in the pulpal inflammation is important so that it can be used clinically to keep the dental pulp vital and healthy. It may thus provide an opportunity to develop potentially new treatment modalities for the inflamed dental pulp in future.