Research question: Are zirconia crowns clinically superior to stainless steel crown in restoring primary molars. Materials and methods: Articles in electronic databases from 2000 to 2020 via PubMed, Google Scholar, Science Direct and Cochrane Central were searched by 2 reviewers and full text of the article was included for assessment based on inclusion and exclusion criteria. Electronic data base search was complemented by manual search of reference of the entire selected full-text article. Study design, sample size, criteria for evaluation and follow-up period were assessed. Results: Search yielded 4,609 titles and 61 articles were considered for full text. Seven randomized control trials on primary molars were included in the review, with follow-up from 12 months to 36 months. Studies have evaluated restorative success and gingival health in zirconia and stainless steel groups. Only one study evaluated radiographic success rate of zirconia and stainless steel crowns in primary molars. As the follow-up period progressed, no plaque accumulation was seen on both the zirconia and stainless steel groups. Six articles were considered for meta-analysis. The study data was found to be heterogeneous and random effects model was used. No differences were found in clinical success rate between zirconia and stainless steel group. Conclusion: Gingival health was superior for zirconia crowns when compared to stainless steel crowns. However clinically, stainless steel crowns are as effective as zirconia crowns.