Apexification is a way to treat young permanent teeth whose roots have stopped growing and developing because the pulp has died. Its goal is to make the root end close without the canal wall getting thicker or the root getting longer. There are two ways to do it: first, with a lengthy operation that employs a calcium hydroxide dressing to allow the body to produce a strong tissue barrier; or second, with a recent short-term procedure that creates an artificial plug at the top of the tooth using MTA or similar bioceramic material. Using the PubMed, Medline, and ScienceDirect databases, a thorough evaluation of the literature spanning 2010 to 2022 was conducted. "Calcium hydroxide," "MTA," and "apexification" were the keywords utilized. The selection of the searched articles was further explained using the PRISMA flowchart. The quality of the included studies was evaluated using the Cochrane risk of bias assessment technique. A total of 7 studies were included in this systematic review, out of which all studies concluded that MTA was a better choice for apexification as compared to calcium hydroxide. MTA was found to be superior to conduct the procedure of apexification successfully as compared to calcium hydroxide. Therefore, it can be used as a material of choice by endodontists in their practice.