Early loss of primary molar may cause a problem for the arch development. The most confident way to prevent the space loss in the dental arches is through the use of space maintainers. Parallel to the improvements in resin composite materials and adhesive systems, there have been innovations in the techniques used for the application of space maintainers in the mouth. The aim of this study was to evaluate the clinical performance of fixed space maintainers combined to open- face stainless steel crowns. For this study, thirteen children having premature loss of primary first or second molar teeth were selected from Pedodontic Clinic, Faculty of Dentistry, Tanta University. Crowns were placed on problematic abutment primary teeth; fixed space maintainers were prepared using 0.9mm Stainless steel orthodontic wire between the window in the facial surface of the crowns and other abutment teeth and were subsequently bonded with flow able composite resin, and the cases were observed over a period of twelve months. The results showed that two space maintainers failed with 84.62% clinical performance rate. There was no significant difference between the initial and final distances measured between the abutment teeth to which the space maintainers were bonded (P>0.05). In conclusion: The study showed the effectiveness of open-face fixed space maintainers placed on the primary molar teeth used as abutment in cases with extensive caries or loss of tooth structure . Open-face fixed space maintainers have high retention and looks more esthetic.