Purpose: compare the chemo-mechanical method of caries removal (CMCR) using Carie-Care™ and conventional technique (Drilling) in normal and disabled Egyptian children. Materials and Method: A total of 40 children were divided into two equal groups .Group A: 20 healthy and normal children. Group B: 20 children with different types of disabilities, either intellectual disability, hearing impairment or visual impairment. Their age ranged from 5-8 years .Two primary carious teeth were chosen in each child according to inclusion criteria (total 80 teeth). The eighty primary teeth from forty children were further subdivided equally into two subgroups (40 teeth in each subgroup) according to caries removal technique. Subgroup Ӏ: caries was removed with CMCR using the Carie-Care system. Subgroup ӀӀ: caries was removed with the conventional drilling technique. Then all teeth were restored with Activa kids bioactive restorative material and followed up at baseline, one month, three months and six months intervals. Results: Results of this study showed that there was no significant difference between patients' groups regarding complete caries removal, total time taken for complete caries removal, pain and patient comfort, but there was a statistically significant difference between both techniques regarding complete caries removal in disabled children group (Group B), and a significant difference was also found in the time taken for complete caries removal , pain and patient comfort in both patients' groups. Also, there was no statistically significant difference between patients' groups regarding the longevity of Activa kids bio-active restorative material at base line, one month, three months and six months follow up periods. Conclusion: Carie‑Care™ gel was an efficacious alternative method to treat carious lesions in both normal and children with different disabilities since it allies atraumatic characteristics. Activa kids bioactive restorative material had an excellent performance as a permanent restorative material in vital primary teeth in both normal and disabled children in a period of 6 months.