Introduction: The aim of this systematic review was to show treatment outcomes of various treatment of cariously exposed vital pulp in permanent teeth which were based on clinical and radiographic examination. Methods: Electronic database: MEDLINE via Ovid, PubMed and Cochrane database were searched. Hand searching was performed through reference lists of endodontic textbooks, endodontic related journals and relevant articles from electronic searching. The random effect method of weighted success rate of each treatment and the 95% confidence interval were calculated by DerSimonian-Liard method. The weighted success rate of each treatment was estimated into four groups: >6 month to 1 year, >1 year to 2 year, >2 year to 3 year and >3year. All statistics were performed by STATA version 10. The indirect comparison of success rate among four follow-up periods of each treatment was performed by proportion z-test (p< 0.05). Results: Overall, the success rate was in the range of 73%-99%. The fluctuation of success rate of direct pulp capping was observed (>6m-1yr; 87.3%, >1-2yr; 95.4%, >2-3yr; 87.7% and >3yr; 72.9%). Partial pulpotomy and full pulpotomy sustained high success rate up to more than 3 years (Partial pulpotomy: >6m-1yr; 97.6%, >1-2yr; 97.5%, >2-3yr; 97.6% and >3yr; 99.4%/ Full pulpotomy: >6m-1yr; 94%, >1-2yr; 94.9%, >2-3yr; 96.9% and >3yr; 99.3%). The success rate of pulpectomy declined significantly from 91.8% in first year recall to 85.4% in more than 3 year of recall (p<0.05). Conclusion: Vital pulp therapy should be considered as an alternative treatment to pulpectomy in vital permanent teeth with cariously exposed pulp. Partial pulpotomy and full pulpotomy provide more predictable outcome than direct pulp capping.