Objectives: Optimal restoration of endodontically treated teeth is very important for the durability of the endodontic treatment. The focus of this study was to evaluate the fracture strength and microleakage of composite endocrowns compared with Class II composite restorations in endodontically treated primary molar teeth. Materials and Methods: 48 extracted second primary molars were divided into 2 groups. Group 1 (control): teeth with Class II and endodontic access cavities restored with G-aenial composite; group 2: endocrown restorations with G-aenial composite. After completing restorative procedures, teeth were subjected to thermal cycling (500 cycles). Compressive loading was applied to half of the samples, although the other half were immersed in 0.5% basic fucsin solution for 24 h, sectioned, and examined for dye penetration under stereomicroscope. Data were subjected to statistical analysis by the Mann-Whitney U test (alpha = 0.05). Results: The fracture strength of endocrowns (1741 +/- 379.35 N) was significantly higher than that of the control group (1126.5 +/- 405.39 N) (P < .05). No statistical difference was found in microleakage between the 2 groups (P > .05). Conclusion: Endocrown preparation increases the fracture strength of the final composite restoration when used in primary molar teeth. Composite endocrown restorations can be a practical and an esthetic option for restoring endodontically treated primary molar teeth.