The present study was conducted to assess the clinical and radiographic success of revascularization approach against the gold standard, well-established apexification and apical plug techniques on management of immature permanent teeth with necrotic pulp and periapical pathosis. Materials & Methods: The selected subjects were divided randomly into two main groups: Group A were treated with regeneration (revascularization) technique and were further subdivided into two subgroups according to the material that was placed MTA or Ca(OH)2.While Group B were treated with apexification technique and were further subdivided into two subgroups according to the filling material that was placed MTA or Ca(OH)2. Results: The clinical success between the four treated subgroups showed no statistically significant difference. However, revascularization with MTA or Ca(OH)2, and MTA apical plug subgroups showed higher clinical success than Ca(OH)2 apexification subgroup. There was no statistically significant difference in clinical success between apexifican and revascularization techniques. However, revascularization showed higher clinical success than apexification. The radiographic success between the four treated subgroups showed no statistically significant difference. However, revascularization with MTA showed the highest radiographic success while Ca(OH)2 apexification showed the lowest radiographic success. There was no statistically significant difference in radiographic success between apexifican and revascularization techniques however, revascularization group showed higher radiographic success compared to apexification group. There was no statistically significant difference between prevalence of apical closure in the four subgroups. However revascularization with MTA showed the highest percentage of apical closure followed by apexification with MTA or Ca(OH)2, followed by revascularization with Ca(OH)2. There was a statistically significant difference between root maturation in the four subgroups. Revascularization with MTA subgroup showed the highest prevalence of root maturation followed by revascularization with Ca(OH)2 subgroup. Ca(OH)2 apexification subgroup showed no root maturation at all. Conclusions: The management of teeth with necrotic pulps and incomplete apex formation using different revascularization protocols and materials was successful in achieving satisfactory clinical and radiographic healing of the periapical pathosis. However the combined use of MTA together with revascularization protocol showed the highest success rate among the four subgroups. There are several advantages of revascularization technique as observed from this study. It requires a shorter treatment time, it can be completed in a single visit. However, the biggest advantage is that of achieving continued root growth (root lengthening) and strengthening of the root as a result of reinforcement of lateral dentinal walls with deposition of new dentin hard tissue.