【Abstract】Objective To explore the clinical efficacy of dental pulp devitalization under local anesthesia in the treatment of acute pulpitis of molars and its effects on perioperative indexes and emergencies of patients. Methods 167 patients with acute pulpitis of molars admitted to our hospital from January 2016 to January 2020 were selected and divided into observation group (84 cases) and control group (83 cases) according to the random number table method. Patients in control group were given straight pulp extirpation under local anesthesia, and patients in observation group were given dental pulp devitalization under local anesthesia. The clinical remission rate, perioperative indexes ［visual analogue score (VAS), treatment time of first visit］, inter-appointment emergency (IAE) grades and incidence rate, and root canal pain grades during return visit were compared between the two groups. Results There were no significant differences in clinical remission rate, IAE grades and incidence rate between the two groups (P＞0.05). After first visit and return visit, the VAS scores of the two groups were lower than those before treatment (P＜0.05), and there was no statistically significant difference between the groups (P＞0.05). The treatment time of first visit in observation group was shorter than that in control group (P＜0.05), and the root canal pain grade at return visit was lower than that in control group (P＜0.05). Conclusion Both dental pulp devitalization and straight pulp extirpation under local anesthesia for acute pulpitis of molars both have good analgesic effects, but cannot avoid IAE. Compared with straight pulp extirpation, dental pulp devitalization has shorter treatment time of first visit and milder root canal pain grade at return visit, and it is more suitable for clinical application.