Purpose: To evaluate the clinical performance of polyethylene fiber for anterior primary teeth restorations in children after 2.5 years, according to modified Ryge criteria. Materials and Methods: Fifty-five maxillary incisors with extensive caries in 24 Iranian patients (mean age 4.2 years) were restored. All teeth were treated endodontically. First, 4-mm layer of paste at the entrance of canal was removed, and a thin base layer of polycarboxylate cement was placed at the bottom of the prepared canal. All tooth surfaces were etched, rinsed and dried, and the dentin adhesive Single Bond (3M ESPE, St Paul, MN, USA) was applied. The teeth received intracanal fiber-reinforced resin (Ribbond Triaxial, Seattle, WA, USA) fixed with a flowable composite and the crowns were reconstructed with microhybrid composite resin (Z250, 3M). All restorations were evaluated every 6 months for 30 months by 2 independent evaluators. Statistical analysis was done with McNemar's test. Results: The surface textures for most of the restorations were judged as excellent. There was no evidence of significant changes in marginal integrity. Most restored incisors (81%) received an Alpha rating for retention. The baseline and recall retention scores differed significantly (p=0.002). Conclusion: Polyethylene fiber posts associated with extensive composite restoration showed excellent clinical performance after 2.5 years in primary anterior teeth after pulp therapy. Keywords: primary anterior teeth, composite resin restoration, polyethylene fiber