Background Periodontal health at the restorative gingival interface continues to represent one of the most difficult challenges. Unfortunately, they only mimic the physical and morphological aspects of teeth, as they are limited by the absence of the 'ideal material' that would provide characteristics similar to the normal tooth structure. Aims To determine the influence of class II amalgam and composite restorative materials on plaque accumulation, gingivitis and periodontal pocket depth. Materials and Methods One hundred patients were included in the study. The age ranged between (21-24) years old. The sample was composed of two groups (50 patients each), with an equal ratio of males and females. The tested restoration types were: amalgam class II (MO) and composite class II (MO) of 2-3 years. The following periodontal parameters: plaque index (PI), gingival index (GI) and pocket depth (PD) in mm were recorded for each restored tooth compared with non-restored tooth on the other side of the mouth as a control. Results The results showed that amalgam induce the higher means of plaque, gingivitis and pocket depth compared with composite. The mean of the three parameters, as compared to control group, were statistically higher in the restored amalgam surfaces (p<0.05). For composite restoration the means of the three parameters were also higher but not in significant levels for both plaque index and gingival Index, except for pocket depth of the restored surfaces were significantly higher than the controlled surfaces. However, there were no significant differences in the ranks of the three mesial indices of patients having amalgam in comparison with those having composite. Conclusion This study suggests that composite restorations did not have a significant advantage on periodontal health over amalgam restorations for Class II posterior teeth.