The aim of this study was to carry out a review of the use and efficiency of preformed metal crowns (PMCs) for primary and permanent molar teeth. A literature search of English language journals was carried out using MEDLINE. Papers that addressed areas related to the use of PMCs regarding indications for use, placement techniques, risks, longevity, cost effectiveness and utilization were included in the review. Eighty-three papers were traced which fulfilled the above criteria, the majority addressing PMCs in primary molar teeth. Over half the papers were concerned with placement techniques and indications for use, with fewer papers reporting on clinical studies. The clinical data on PMCs spanned a considerable number of years and involved heterogeneous populations of patients, different makes and designs of crown, and differences among the operators and evaluators who were involved in the studies. The results, however, were in agreement that PMCs are superior to amalgam restorations for multisurface cavities in primary molar teeth.