Minimally invasive dentistry focuses on preserving tooth structure through biomimetic restorations that replicate natural teeth both aesthetically and functionally. Deep carious lesions extending below the gingival margin pose clinical challenges like compromised isolation, moisture control, bonding, and impression accuracy. Restorations beyond the cemento-enamel junction risk biological width violation, potentially causing periodontal issues. Deep Margin Elevation and Acquisition (DME&A) offers a conservative solution by elevating subgingival margins using composite resin, improving rubber dam isolation, bonding, and impressions while safeguarding periodontal health. When combined with immediate dentin sealing, DME&A boosts bond strength, marginal integrity, and cusp reinforcement, facilitating optimal adhesive restorations. Research shows DME&A, if performed with proper isolation, is periodontally safe and clinically successful.