Extraction was considered the treatment of choice for managing a primary tooth with an inflamed or necrotic pulp. Clinicians were hesitant to attempt root canal treatment in necrotic primary teeth due to their unfamiliarity with narrow tortuous canals, flared roots, and the concern about causing damage to the permanent successor. With better understanding and improved skills, pulpectomy, a non-vital pulp therapy procedure, has now become a reliable treatment modality in primary teeth. This chapter takes readers through the clinical indications and contraindications of pulpectomy and gives a workflow of access opening, working length estimation, chemicomechanical preparation of the canals using rotary systems suited to primary tooth anatomy, and obturation using various resorbable root canal filling materials.