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Purpose: Assess the effect of material selection as well as different fabrication techniques of metal ceramic (MC) and all ceramic crowns on their clinical outcomes, marginal and internal fit. Materials and methods: In vivo study(I); twenty-eight patients were provided with twenty-eight crowns restoring mandibular first molar tooth.Patients were distributed into 2 groups and 2 subgroups according to different materials and fabrication techniques: fourteen patients received MC crowns, group (I); seven patients received crowns with conventional casting of Co-Cr copings, subgroup (A) and seven patients received crowns with direct milling of Co-Cr copings, subgroup (B). Fourteen patients received IPS e.max press crowns, group (II); seven patients received crowns with conventional wax pattern, subgroup (A) and seven patients received crowns with 3D printing resin pattern, subgroup (B). The survival rate of these crowns was evaluated and statistically analyzed. In vitro study(II); one machined die was prepared to simulate crown preparation of mandibular first molar tooth. 60 crowns were constructed on die and divided into 2 groups (30 samples each) and 2 subgroups (15 samples each) according to different materials and fabrication techniques similar to in vivo study. Replica technique obtained to measure marginal and internal fit using Digital microscope. Results: The survival rate of MC and press crowns was 98% and 60% respectively. Press crowns and digital technique showed superior marginal and internal fit than MC crowns and conventional technique respectively. Conclusions: Material type and fabrication technique of MC and all ceramic crownsinfluence their clinical outcome, marginal and internal fit.