Aim: The present randomized clinical trial is aimed at evaluating clinical efficiency of two different types of esthetic crowns—polymethyl methacrylate crowns and vacuum formed thermoformed crown as an alternative to full-coverage coronal restoration for deciduous molars. Materials and methods: A total of 45 primary molars in pediatric patients were selected using randomization and split into three groups based on the technique used for preparation of crowns: group I—polymethyl methacrylate crowns; group II—thermoformed crown; and group III—stainless steel crowns (SSC). All crowns were clinically and radiographically evaluated at baseline, 1st month, and 3rd month for gingival health, retention, marginal integrity, proximal contacts, occlusion, alignment, and staining. Statistical analysis: The data was tabulated and analyzed by Statistical Package for the Social Sciences (SPSS) Version 23.0 software. The intergroup comparison was done by Kruskal–Wallis test, analysis of variance (ANOVA), and Mann–Whitney U test for continuous data. The intragroup comparison was done by Friedman test and Wilcoxon signed-rank test for categorical data. All p-values < 0.05 were considered statistically significant. Results: With regard to the parameters of plaque score, gingival index score, occlusion, interproximal contacts, retention, alignment, and marginal adaptation, no statistical significance was noted between the three groups. However, with regard to the discoloration (staining) when the polymethyl methacrylate acrylic (PMMA) group was compared with thermoforming group, statistical significance was noted in 1st month with p-values of 0.04 and 0.03, respectively. On intragroup comparison, statistically significant values were obtained in SSC group for plaque score and thermoforming group for gingival index score. Clinical significance: The study concluded that the PMMA and thermoforming crowns can be used as an alternative to SSC for restoring the primary molars as they showed equivalent results to that of standard SSC.