Aim: To clinically and radiographically assess the effectiveness of Aloe vera compared to Mineral Trioxide Aggregate (MTA) as a direct pulp-capping material. Materials and methods: Forty patients, aged 14–30 years, who had immediate mechanical pulp exposure in their mandibular first permanent molars during class I cavity preparation were gathered from the Restorative Dentistry Department Clinic, Faculty of Dentistry, Tanta University. They were randomly divided into two groups of equal size (n = 20) based on the pulp-capping material used: Group I: pulp exposures were capped using Aloe Vera, and Group II (control): pulp exposures were capped using MTA. In both groups, the remaining part of the cavity was filled with composite resin restoration. The treated teeth were assessed clinically and radiographically at different intervals (baseline, 3, 6 months postoperatively). Data from both groups were statistically analyzed at a 95 % significance level at different study intervals. Results: Both groups initially had clinical, radiographic, and overall success rates of 100%. These rates decreased to 94.7% at the 3-month follow-up for both groups except the clinical success for group I and 94.1% at the 6-month follow-up for group I while group II rerecorded 100%. The final clinical, radiographic, and overall success rates were 94.1%, 88.2%, and 88.2%, respectively, for group I and 94.4% for group II. There were no significant statistical differences between the two groups (p > 0.05). Conclusion: Aloe vera was as effective as MTA as a direct pulp capping material, despite MTA offering superior clinical and radiographic success