Objectives : The present clinical trial was conducted in order to compare Bioactive composite (ACTIVA Presto) to high viscosity glass hybrid reinforced Glass Ionomer (EQUIA Forte) in class II cavity restorations. Material and methods: A total of 22 participants randomly received 22 proximal restorations using either; ACTIVATM PrestoTM by Pulpdent Corp. (Watertown, MA, USA) or EQUIA® Forte Fil HT GC Corporation (Tokyo, Japan.). Cavity preparation was done followed by restorative material application according to manufacturers' instructions. Restorations were assessed using modified USPHS criteria by two blinded assessors at baseline, 6 and 12 months regarding retention, marginal discoloration, marginal adaptation, post-operative hypersensitivity, anatomical form and survival rate. Results: After 12 months there was no statistically significant difference between both materials regarding retention, marginal discoloration, marginal adaptation, color match, anatomical form, post-operative hypersensitivity and survival rate (P=0.8273, P= 0.1665, , P= 0.9449, P= 0.0601, P=0.0796, P=0.9449, P = 0.057 ) Concerning the primary outcome proximal contact, there was a statistically significant difference between both materials at 12 months (P= 0.0246) . As for surface texture there was a statistically significant difference at 12 months between both materials (P = 0.0128). Nonetheless, there was no statistically significant difference between both restorative materials regarding survival rate after 12 months. Conclusion: ACTIVA Presto is highly recommended as a reliable permanent restoration especially for proximal cavities. EQUIA Forte is not advised to be used as a permanent restoration in proximal cavities.