Aim: The present study aimed to investigate the association of fingerprint patterns with the behavior of the child during extraction under local anesthesia. Materials and methods: The study was conducted among 50 children aged 4–9 years old. After getting informed consent from their parents, the extraction of primary mandibular molars was carried out under local anesthesia. The behavior of the children was noted during the extraction process. In the subsequent stage, the fingerprint was collected by placing the right and left thumb on the ink stamp followed by the impression on a white sheet. The thumbprint impression was categorized based on the types of fingerprint patterns and it was statistically analyzed. The Chi-squared test was done to find the association of fingerprints with behavior. Results: The left thumbprint showed 10 arch patterns, 24 loop patterns, and 16 whorl patterns, and the right thumbprint showed four arch patterns, 26 loop patterns, and 20 whorl patterns. The majority of the children with loop patterns showed Frankl's positive behavior, however, there was no significant relation between fingerprint pattern and cooperation of the child. Conclusion: There was no significant relationship between the fingerprint patterns and behavior of children aged 4–9 years during extraction under local anesthesia. Clinical significance: Assessment of children based on their behavior is one of the most important skills for a pediatric dentist. Fingerprint patterns might aid in predicting the degree of cooperation by children during dental procedures. The identification of children's behavior might help in choosing the appropriate behavior management technique to deal with the children in the dental office.