Aim: aim of the present study was to evaluate and compare the clinical and antimicrobial efficacy of garlic extract and formcresol as a non-vital pulp therapy medicament in primary teeth. Subjects and methods: The clinical study was conducted on 30 children of both sexes between the ages of 4 and 7 year. A total of 60 non-vital bilateral primary mandibular molars (first&second) were selected for nonvital (mortal) pulpotomy procedures at two visits: 7 days apart. Treated teeth are classified into two groups according to the drugs used in the treatment. The first group (control group) was dressed with formocrysol, while the second group (study group) was dressed with garlic extract (GE). Microbiological samples were collected from each of the 60 specimens before treatment and 7 days later. Results: The results showed that pain disappeared in both groups significantly, with success rates of 95.2% and 95.6%, respectively. Other indicators were assessed with a 100% success rate of swelling and mobility for both groups. Conclusion: Clinical and microbiological analysis of this study revealed that there are potential natural alternative medicaments (GE) for formacresol, which can be considered equally effective.