The aim of this systematic review was to evaluate the clinical and radiographic success rates of primary teeth pulpotomy using 3Mixtatin compared to mineral trioxide aggregate (MTA). A comprehensive literature search identified relevant studies, which were screened for inclusion, with the risk of bias assessed using Cochrane collaboration tools. Data on success rates, follow-up periods, and methodological quality were extracted, and the protocol was registered in PROSPERO (ID: CRD42024562155). Among the four analyzed studies, Jamali et al. reported 24-month clinical success rates of 90.5%, 88.1%, and 78.9% for 3Mixtatin, MTA, and formocresol, respectively. Chak et al. observed a 95.7% clinical success rate for 3Mixtatin over 12 months, with no data on MTA, while Mushtaq et al. found comparable success rates for both 3Mixtatin and MTA. Reddy et al. reported clinical and radiographic success rates of 91.7% and 81.7% for formocresol, 100% and 91.7% for MTA, and 95% and 85% for 3Mixtatin at 6 and 12 months, respectively. Radiographically, 3Mixtatin demonstrated slightly better short-term outcomes than MTA. These findings suggest that both 3Mixtatin and MTA are effective for pulpotomy in primary dentition, with 3Mixtatin offering potential advantages due to its antibiotic and statin properties that may enhance healing and antibacterial effects. Additional studies involving larger and more diverse populations are required to confirm these findings.