Adhesive dentistry employing principles of minimal invasiveness considered a game changer when considering restoration of endodontically treated posterior teeth. Deep proximal margins created a challenge during different restorative procedure that could be faced by the clinicians. Aim: The current clinical trial was conducted to evaluate the postoperative pain following deep margin elevation in comparison to surgical crown lengthening for indirect restorations in endodontically-treated posterior teeth with deeply located proximal margins. Methods: A total of 20 deep proximal cavities in endodontically treated posterior teeth were randomly assigned into two groups (n=10); Deep Margin Elevation (DME) or Crown Lengthening (CL). Pain records were taken from the patients postoperatively immediately after both procedures. Results: There was a statistical significant difference was found between the two groups with median pain score for the Deep margin elevation group lower than crown lengthening group. Conclusion: Deep margin elevation approach could offer a more conservative solution with predictable results when consider relocating deeply seated proximal margins in a more coronal position. Applying the DME approach resulted in marked reduction in post-operative pain favoring this restorative technique in managing deeply located subgingival margins