Stainless steel crowns are even now, the best available option to restore deciduous molars with extense decay involving at least one proximal surface. Composites restorations are only an alternative to stainless steel crowns in those cases with vaste occlusal decay with no proximal involvements, even when a pulpal therapy has to be performed. With a standard technique which has remained almost unchanged, the gingival tissues response to crowns and its long term clinical results, are excellents. Preformed or non preformed ones are not two different options to work with, but two choices to consider depending the professional aptitudes and the particular condition of the tooth to be restored. Finally in those cases where the deciduous molar cannot be acceptably restored with a stainless steel crown, no new material has shown to be a reasonably alternative; then, extraction of the tooth has to be considered and adecuate measures will be taken in order to maintain the physiological occlusal development of the child inaltered.