Aim: The purpose of this study was to compare the effect of pulpotec and calcium hydroxide intracoronal dressing on interappointment pain relief for symptomatic posterior teeth with acute pulpitis with apical periodontitis. Materials and methods: The trial design of this study is parallel randomized controlled trial.44 participants were selected randomly allocated into two groups(22 each), treated with standardized pulpotomy procedure, each tooth received an intracoronal dressing from one of the two materials (calcium hydroxide and pulpotec group) according to group to which patient was allocated, followed by a zinc phosphate base, and amalgum as final restoration. Both materials were evaluated for their efficiency in relieving pulpitis pain after 48 hours using Visual analogue scale, and their effect by time on interappointment pain, and healing of inflamed pulp and periodontal membrane by clinical and radiographic examination at follow up visits at 1,3 and 6 months. Results: The primary outcome of this study showed that both materials resulted in clinically significant reduction in post endodontic pain at all post-operative follow-up periods. ; However Ca(OH)2 Group showed higher mean VAS score than Pulpotec Group. After 1months, all cases in Ca(OH)2 Group required shift to conventional root canal treatment ; meanwhile all cases of pulpotec (100%) showed sound clinical and radiographic condition. after 6 months, two cases from PD group were shifted to conventional root canal treatment; with total success 0f 90.9%. Conclusion: Pulpotec was effective in relieving pain of acute pulpitis associated with apical periodontitis within 48 hours, and up to 6 months post-operatively while Calcium hydroxide succeeded in relieving pain within 48 hours; however it failed to relief pain over long period of time, and failed to improve the periodontal condition.