Purpose: To clinically evaluate whether 4% articaine administered alone as a single buccal infiltration in deciduous maxillary tooth extraction can provide favorable palatal anesthesia compared to buccal and palatal infiltrations using 2% lidocaine. Materials and methods: A prospective, double-blind, split-mouth, randomized controlled clinical study was carried out on 60 children comprising 36 females and 24 males in the age group of 5–10 years. During two separate appointments, children randomly received either 4% articaine with 1:1,00,000 epinephrine (group I—experimental) as buccal infiltration alone, or 2% lidocaine with 1:80,000 epinephrine (group II—control) as buccal plus palatal infiltration. Second local anesthetic agent was administered at least 1 week apart from first administration. Efficacy of anesthesia was assessed using subjective [Wong–Baker Faces Pain Scale (WBFPS)] and objective [sound, eye, motor (SEM)] scales along with occurrence of any adverse effects. Results: For infiltration procedure, 4% articaine (group I) had statistically highly significant (p < 0.001) pain scores on WBFPS as well as on SEM scale compared to 2% lidocaine (group II). According to WBFPS (p = 0.43) and SEM (p = 0.32) scores, the pain on extraction between 4% articaine and 2% lidocaine was statistically insignificant. Conclusion: About 4% articaine buccal infiltration showed better clinical anesthetic efficacy, thus providing effective palatal anesthesia due to its enhanced vestibule-palatal diffusion with no significant postanesthetic complications. Hence, articaine can be used as an alternative to lidocaine in children for extractions of deciduous maxillary teeth.