Abstract: Objective： To compare the clinical and radiographic outcomes of pulp revascularization and apexification on immature permanent necrotic teeth with apical periodontitis. Methods： Clinical and radiographic data were collected from 26 immature permanent teeth with apical periodontitis at Affiliated Stomatology Hospital of Nanjing Medical University(follow-up time lasted up to 6 months). Teeth treated with pulp revascularization were in the experimental group while those treated with apexification were in the control group(13 cases per group). Clinical success rate was evaluated. The increase of root length, radiographic root area(RRA) and apical diameter of the revascularized teeth and the apexificated teeth were measured and compared according to the periapical radiographs. Results： At the end of 3 months’ follow-up, the experimental group showed a significant change in apical diameter and radiographic root area compared with the control group（P<0.05).There was no significant difference in the root canal length between the two groups. At the end of 6 months’ follow-up, the experimental group showed a significant change in radiographic root area compared with the control group（P<0.05).There was no significant difference in the root canal length and apical diameter between the two groups. Conclusions： Pulp revascularization in immature permanent necrotic teeth with apical periodontitis showed a better outcome than apexification.