Introduction: Full-coronal restoration is the choice of treatment for restoring pulpally treated tooth or tooth with multiple surface involvement. In paediatric dentistry, semi-permanent stainless steel crowns (SSCs) are considered gold standard, but with increasing need of aesthetics, zirconia crowns have started gaining importance. Hence, this study was conducted to evaluate the clinical performance of SSCs and zirconia crowns and to compare the child satisfaction and parental ratings of impact of treatment using these preformed crowns. Materials and Methodology: This study was a part of randomised controlled trial performed on 60 children of 4–8 years old. The primary molars were cemented with either SSCs or zirconia crowns and were evaluated clinically at baseline, 6-month and 12-month follow-up for crown retention, crown fracture, gingival and debris index, wear, marginal integrity and recurrent caries. The trials also evaluated parental satisfaction and child satisfaction based on five-point Likert scale at the end of 12-month follow-up. The data were analysed using Chi-square test for categorical data and independent sample t-test for quantitative data. Results: Both the crowns were 100% retentive at 12-month follow-up. Fair debris score and mild gingivitis were reported in 3% with SSC at 6–12 months. One zirconia crown fractured at 12 months. Fifty-four per cent of parents in zirconia and 57% in SSC stated that the crowns improved masticatory function. Children reported a mean Likert score of 3.0 for SSC and 4.89 for zirconia which was highly significant. Conclusion: Both the crowns increased the overall health of crowned tooth and were fully retentive for the studied duration. However, zirconia crowns were more gingival friendly and had an edge over SSC in terms of aesthetics.