Background: Secondary caries arise at the contact of a natural tooth and a prosthetic repair. The present investigation employed two clinical methodologies, namely Caries associated with restoration or sealants (CARS) and the International Dental Federation (FDI), to evaluate and manage secondary caries in permanent posterior teeth. Objective: The goal of this research is to compare the diagnostic efficacy of FDI and CARS visual criteria for assessing secondary caries in permanent posterior teeth, to identify the more reliable and effective clinical approach for improved treatment planning and patient outcomes. Method: This was conducted at the School of Dentistry Pakistan institute of medical sciences Islamabad, after approval from the ethical committee. The sample size is 160 patients. In this study, two clinical criteria being assessed included one representing the FDI system which includes the marginal staining, marginal adaptation, and caries' recurrence, while another one was Caries associated with restoration or sealants (CARS) based on ICCMS (International Caries Classification and Management System) for evaluation and treatment of secondary caries. Results: A total 650 restorations were assessed, with a mean age of 30.83 years (SD +/- 2.68). While comparing, there was a strong correlation to the presence of caries lesions (Rho=0.64), and for Marginal adaptation, it was (Rho=-0.45), which depicts a weak inverse correlation. There was a moderate correlation between the two criteria (Rho=0.64,) The majority of CARS visual criteria decisions recommended no treatment in comparison to FDI criteria Conclusion: It is concluded that the FDI system is a more aggressive approach, suggesting a higher number of restoration replacements than the CARS which is less invasive. As a result, the method used to assess secondary caries may result in more or less invasive suggestions for treatment.