Aims <p>This study explored the diagnostic and treatment practices of Palestinian general dentists related to minimally invasive dentistry (MID) and identified perceived barriers to its broader application.</p> Materials and methods <p>A cross-sectional online survey collected data from general dentists on demographics, MID-related practices, and barriers. Descriptive and inferential statistics were used to evaluate current practices and their associations with dentist demographics and professional characteristics.</p> Results <p>A substantial proportion of dentists applied MID-related principles. Preventive, nonoperative approaches are slightly more common for occlusal lesions and more clearly favored for approximal lesions. Approximately two-thirds adopted conservative cavity designs such as vertical slots or saucer-shaped preparations, whereas approximately half preferred selective removal for deep caries. Most dentists opted to repair rather than replace defective restorations. Clinical experience had a stronger influence on these practices than gender or workplace setting did, and the main barriers included limited training, restricted access to modern materials and technologies, and low patient awareness.</p> Conclusion <p>Palestinian dentists demonstrated variability in the application of MID-related practices, with greater use reported among more experienced practitioners and those in private practice. Addressing educational, infrastructural and cultural barriers could support broader integration of evidence-based, minimally invasive approaches into routine care. These findings set the foundation for developing national policies, curricular reform, and continuing education, underscoring their importance in advancing evidence-based, minimally invasive care in Palestine.</p>