Background: An endodontic management of the primary teeth is important considering the various untoward consequences associated with its premature loss. Aim: To compare the patient acceptability with manual and rotary methods of root canal instrumentation during pulpectomy. Materials and methods: Pulpectomy treatment was carried out in 60 pulpally infected the primary teeth among children aged 4–7 years. Thirty teeth were instrumented with manual and rotary methods of root canal instrumentation. Patient acceptability during instrumentation was recorded by an independent evaluator using a modified patient acceptability scale. Results: Children accept treatment readily with manual technique; however, no statistically significant difference was observed between manual and rotary techniques of root canal instrumentation. Conclusion: Acceptability of root canal instrumentation in children is comparable with manual and rotary techniques.