Dental caries is the most prevalent disease in humans, especially during early childhood. The restoration of such an extensive carious lesion should be done properly to reestablish their anatomy and hence their masticatory, phonetic, esthetic and space-maintainer functions in the dental arches. The consequences of premature loss of primary teeth are well known, namely the loss of vertical dimension of occlusion, tongue thrusting and mouth breathing habits, which can be the sources of future malocclusion. Satisfactory restoration of these teeth, improving esthetics, along with the management of space and function has always been a challenge for pediatric dentist. An ever increasing demand for esthetics has led to innovation and development of newer treatment modalities for these problems. In an attempt to widen the treatment options as biologically and conservatively as possible, tooth structure is used as a restorative material to rehabilitate severely destroyed tooth crowns. This technique consists of bonding sterile dental fragments, obtained either from the patient or from a tooth bank, to the teeth. Such a technique was termed as ‘biological restoration’. This article aims at reviewing the evolution, techniques and outcome of such biological restorations. How to cite this article: MD Indira, Dhull KS, Nandlal B, Kumar PSP, Dhull RS. Biological Restoration in Pediatric Dentistry: A Brief Insight. Int J Clin Pediatr Dent 2014;7(3):197-201.