Several pulp therapies were developed to maintain the health and integrity of the teeth pulps because of their necessity for physiological growth of healthy permanent teeth with a long-term preserved function. Pulp therapies aims mainly at protecting the teeth that were affected by caries, infection, or trauma. Pulpotomy and pulpectomy are the most common utilized pulp therapies, and the choice between them depends on several factors, for instance, the vitality of the existing pulp, the portion of the pulp involved (e.g. coronal versus radicular portions), the presence or absence of reversible/irreversible pulpitis, the presence or absence of a necrotic pulp, the state of surrounding bones and soft tissues, and the presence or absence of infection, abscesses, fistulae, or underlying cysts. Basically, pulpotomy is usually therapy of option in patients with vital pulps, whilst pulpectomy is preferred in cases with non-vital teeth pulps. This article will review and summarize the main differences between pulpotomy and pulpectomy particularly regarding their definition, indications, techniques, and complications.