Objective: This systematic review and meta-analysis aimed to evaluate the overall, clinical, and radiographical success rates of alternative pulpotomy medicaments in primary teeth. Methods: A systematic search of five databases was conducted following the PRISMA guidelines. Prospective clinical trials utilising alternative pulpotomy medicaments in children were included. The outcome measures were overall, clinical, and radiographic success, expressed in percentages and converted to odds ratios (OR). Fifteen articles were included in the meta-analysis. Results: combined OR for overall, clinical, and radiographic success was 0.55 [95% CI: 0.12-2.41; P=0.42; I 2 =76%], 1.03 [95% CI: 0.57-1.86; P= 0.92; I 2 =0%] and 0.84 [95% CI: 0.54-1.47; P=0.66; I 2 =34%], respectively. The results suggest an inconclusive outcome in the success rate of alternative medicaments. Conclusions: There is insufficient evidence to support the efficacy of alternative pulpotomy medicaments for use in primary teeth. Further robust studies are required before such alternative medicaments should be used in clinical practice.