This retrospective cohort study evaluated overall parental satisfaction of zirconia crowns (ZC) placed on primary maxillary anterior teeth with that of two independent, blinded dentists. 131 ZC placed in 37 children, aged 24.8-62.2 months (mean = 42.8), who had at least one recall visit a minimum of 6 months after placement were rated (average = 13.3). Crown colour match, crown contour and crown durability were evaluated by parents and compared to photographic evaluations of two independent raters. Overall parental satisfaction was also evaluated. The overall retention rate was 99.7% and parental satisfaction was 100%. Colour match was rated excellent by 84% of parents and 36% of dental evaluators. Crown contour was rated excellent by 97% of parents and 55% of dental evaluators. The length of follow-up had no effect on colour match or crown contour. ZC comprises an aesthetic and durable option for restoring carious primary maxillary incisors and were well-accepted by parents. Parents were less critical than dental evaluators of crown appearance.