OBJECTIVE To compare the efficacy of Aloe vera (AV) gel versus Ferric : Sulphate (FS) as a pulp medicament in vital pulpotomy of deciduous molars. METHODS: This randomized controlled trial was conducted at Peshawar Dental College, Peshawar, Pakistan. One hundred and fourteen patients were randomized into interventional group (A): who received AV gel & control group (B): who received FS as pulpotomy medicament. Deciduous molars of patients of both genders were selected for this study. Clinical signs & symptoms and radiological findings were observed in both groups after a period of 6 months and then checked for their comparative efficacy. RESULTS: Out of 114 patients, 69 (60.5%) were males. Postoperative pain was reported be as no pain [AV=44/57 (77.2%); FS=43/57 (75.4%)], mild pain [AV=07/57 (12.3%); FS=11/57 (19.3%)], moderate pain [AV=03/57 (5.3%); FS=01/57 (1.8%)] and severe pain [AV=03/57 (5.3%); FS=02/57 (3.5%)]. Periapical abscess was observed in total of 04/114 (3.5%) patients (AV=03/57; FS=01/57). Pathological tooth mobility was also present as mild/normal [AV=52/57 (91.2%); FS=56/57 (98.2%)], moderate [AV=04/57 (7%); FS=01/57 (1.8%)] and severe [AV=01/57 (1.8%)]. Radiographic changes were found in total of 06/114 (5.3%) patients (AV=04/57; FS=02/57). Out of 114 patients, 51/57 (89.47%) cases remained successful in group A while in group B, 54/57 (94.73%) were successful. CONCLUSION: AV tends to prove favorable outcomes in terms of clinical signs and symptoms and radiological features comparable to ferric sulphate and could be a better & cheap alternative to other medicaments in future and can be used safely for pulpotomy.