The chapter starts off with indications and contraindications for Class II amalgam restoration. General features of Class II preparation designs like outline form, resistance and retention form and various factors that influence the above mentioned forms. Cavity preparation for Class II restoration is explained in detail starting with initial outline form and proximal box establishment. Final cavity preparation explains about removal of remaining caries, old restorative material and if required establishment of secondary resistance and retention features. Modifications of conventional Class II preparation are explained. Under section of contact and contours the section starts off with explaining about basic dental morphology terms like height of contour, marginal ridge, interproximal spaces, and embrasures. Procedures for establishment of contact and contours like tooth movement and matrixing is explained in detail. Tooth movement classification and types, Matrix bands and retainer classification and types are explained also objectives and qualities of good matrix are explained. Marzouk designs of Class II preparation are outlined. The chapter finishes off with explanation about features of Class II preparation and common pitfalls and failures in Class II amalgam restoration.