Objective: To evaluate the clinical performance and radiographic outcome of glass ionomer cement (GIC) restoration in primary molars using three caries removal techniques. Basic research design: Randomised clinical controlled trial. Clinical setting: Two standard dental clinics in 2 hospitals near Bangkok. Participants: A total of 276 children, aged 6-11, having dentinal caries on the occlusal and/or proximal surface extending at least one-third of dentine without signs and/or symptoms of irreversible pulpitis. Intervention: Children were randomly allocated into 3 study groups with different caries removal techniques: Group 1, partial soft caries removal at enamel-dentine junction (EDJ) by spoon excavation; Group 2, complete soft caries removal by spoon excavation; and Group 3, conventional caries removal by steel burs. All cavity preparations were restored with GIC (Fuji IX, GC Corp., Japan). Main outcome measures: Clinical and radiographic evaluations were carried out at 6 and 12 months after restoration. Results: After 12 months, 89, 89, and 88 restorations in Groups 1, 2 and 3 were evaluated. The cumulative survival rates of GIC restorations in Groups 1, 2 and 3 were 83%, 83%, and 89% while the cumulative survival rates of pulp were 99%, 100% and 98% respectively. There were no statistically significant differences in the survival of GIC restorations or pulp in the three groups (p>0.05). Conclusion: The clinical and radiographic evaluations after 12 months indicated that partial soft caries removal at EDJ followed by GIC restoration was comparable to that of ART and conventional approaches. © BASCD 2012.