Object: The aim of this study was to report the reasons for placement and replacement of direct restorations in private general dental practices in Brazil. Method and Materials: Thirty-seven practitioners recorded information regarding 16 consecutive direct restorations placed by themselves in a 4-week period. The information recorded reported the patient's age, gender, tooth number, the class of restorations, the restorative material used, and the reasons for placement and replacement of amalgam and tooth-colored restorations. The data were statistically analyzed through chi-square tests. Results: The average age of the patients was 37 years, with female patients occurring more frequently. Of all the restorations placed (n = 551), 39.75% were first-time placements, while 60.25% were replacements. For first-time restorations, the primary reason for placement was primary caries, followed by noncarious tooth substance loss. For amalgam restorations, the main reason for replacement was to obtain improved esthetic appearance with a tooth-colored material. For restorations of resin composite, secondary caries was the principal reason of failure. The resin composite was statistically (P .01) the most indicated material (88.93%) for the placement and replacement of restorations. Conclusion: Replacements have been the main reason for performing direct restorations, and the chosen restoration material was resin composite. Keywords: amalgam, primary caries, replacement, resin composite, restoration, restorative material, secondary caries