The Cvek pulpotomy procedure has been in use for over 40 years since the technique was first published in 1978. The original technique remains unchanged; however, the materials used have evolved considerably. This article explores the developments in materials and the clinical procedure since the late 1970s and discusses how they might influence outcome. Two cases are presented to demonstrate common clinical scenarios that a general dental practitioner may encounter in everyday clinical practice. The treatment performed with the available materials is critiqued. Keywords: Cvek pulpotomy, direct pulp cap, mineral trioxide aggregate (MTA)