Aim: To elucidate the clinical and radiographical success rate of triple antibiotic paste (TAP) using lesion sterilization and tissue repair (LSTR) therapy in primary molars. Materials and methods: Electronic databases and gray literature were screened from 1^st January 2004 to 30^th September 2020 for randomized controlled trials (RCTs), and clinical trials that assessed the success of LSTR therapy in primary molars were chosen for the review. Two independent reviewers were involved in the selection of studies, extraction of data, assessment of bias using Cochrane Collaboration's tool in accordance with Review Manager software, and revised, validated version of methodological index for nonrandomized studies (MINORS) criteria, clinical and radiographic success of TAP. Results: Eight studies were selected for qualitative analysis where the risk of bias varied from low to unclear according to the Cochrane tool's domains. Overall, studies showed a high risk of bias and a low level of evidence. Included studies demonstrated clinical success rate ranged from 83.3 to 100% at 12 months, 82.3 to 84.2% at 18–21 months, and 82.7% at 24–27 months, while radiographic success rate ranged from 45.8 to 90% at 12 months, 40.7 to 76.4% at 18–21 months, and 36.7% at 24–27 months recall visits. Conclusion: Lesion sterilization and tissue repair (LSTR) therapy using TAP showed favorable clinical success but a low radiographic success rate in primary molars. Clinical significance: Lesion sterilization and tissue repair (LSTR) therapy can be a suitable alternative treatment option to salvage a tooth with a poor prognosis. Literature supports the rationale of employing LSTR therapy in such situations, thereby restricting the need for the premature extraction of a primary tooth.