OBJECTIVES: The present study aimed to assess parental acceptance of silver diamine fluoride (SDF) treatment for dental caries in children in Najaf city, Iraq. METHODS: A cross-sectional design was used, involving 670 parents of children aged 6-7 years from primary schools in Najaf city, Iraq, during the academic year 2023-2024. The participants were selected via a multistage random sampling method. A structured questionnaire was administered to gather the participants' views on tooth staining caused by SDF application to cavitated teeth. Statistical procedures included descriptive analysis, chi-square tests, and ordinal logistic regression. RESULTS: In total, 670 parents were recruited for this study. The mean age of the participants was 34.47 ± 8.2 Approximately half of the respondents were male and aged 31-50 years, and approximately three-fourths of the parents reported having a low education level and were in the low-income category. Parental acceptance of SDF treatment was greater for posterior teeth, with 51.2% agreeing, and 24.2% strongly agree. For anterior teeth, acceptance was lower, with only 23.3% agreeing and 10.7% strongly agreeing. Parental age (p = 0.008), education level (p <
0.001), and income (p = 0.003) were significantly associated with acceptance of SDF treatment for posterior teeth. However, for anterior teeth, parental education (p <
0.001) and income (p = 0.029) were significantly associated with acceptance of SDF treatment. CONCLUSION: Parents showed high acceptance of SDF treatment, particularly for posterior teeth, although concerns about aesthetics affected their views of anterior teeth. Improving parents' awareness and addressing their apprehensions could increase the adoption of this evidence-based caries management approach for children.