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Background: Sodium hypochlorite (NaOCl) gel has been suggested as a safer substitute in open apices as compared to solution, with the same antimicrobial effect., Objectives: This study aimed to compare the amount of the apical extrusion of NaOCl gel and solution in immature permanent teeth., Material and Methods: A crossover in vitro study was conducted at the Department of Pediatric Dentistry, Faculty of Dentistry of Damascus University, Syria. Thirty freshly extracted immature single-rooted human premolars were decoronated and the cavity was then accessed. The teeth were radiographed to determine the mesiodistal dimension of the apex. In addition, the surface area of the apical foramen was calculated with Adobe Photoshop® to evaluate the amount of extrusion from the whole surface of the apex. The teeth were divided into 2 groups according to the size of the apex: ≤2.5 mm (group A) and >2.5 mm (group B); each group was irrigated with 5 mL of NaOCl solution and 2 different commercial types of NaOCl gel for 60 s, and then the extruded irrigant was measured in a plastic vial., Results: The data was analyzed using the Kruskal-Wallis analysis. Based on the observed results, a statistically significant difference was noted (p = 0) between NaOCl solution and gel when the apical diameter was ≤2.5 mm, while there was no significant difference between the 2 types of NaOCl gel. No statistically significant difference was observed (p = 0.2) between NaOCl solution and gel when the apical diameter was >2.5 mm., Conclusions: Sodium hypochlorite gel is safer than solution when irrigating immature teeth with the apical diameter ≤2.5 mm.