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The pulpal pathways in primary teeth differ significantly from permanent teeth due to their larger pulp chambers, thinner dentin walls, and increased susceptibility to caries and trauma. The root canals are often irregular, with multiple accessory canals and natural resorptive changes as the tooth approaches exfoliation. These anatomical variations make endodontic treatment more challenging, requiring careful access opening and minimal removal of tooth structure. The complex morphology, along with a higher risk of perforation and incomplete debridement, necessitates a thorough understanding of the pulpal anatomy. Proper treatment planning ensures the preservation of primary teeth until their natural exfoliation, supporting the healthy eruption of permanent successors.