Background: Radiography is a commonly used imaging modalityin dental setup to aid in diagnosis. Digital radiography usingradiovisiography (RVG) is a direct digital intraoral radiographicimaging system, requiring a substantial reduction of radiationdosage to the patient over other radiographic techniques usingthe film.Objective: This study was undertaken with the aim of comparing thesensitivity of RVG system with intraoral periapical radiograph and also to evaluate thediagnostic accuracy of RVG to conventional radiography along with clinical examination in detection of initial caries.Material and Method:Two bitewing radiograph were taken both intraperiapical radiograph(IOPA) and Radiovisiograph(RVG) of same patient. The conventional radiograph was then taken using size 2 Carsteem Ultraspeed (D-speed), double pack film (Carsteem Company,Rochester, NY, USA) exposed with Bio-dent-1070-D-x-ray unit (Bio medicareCoperation, DistThane, Maharastara , India) following the posted guidelines (70 kVp, 8Ma, 25 pulses).The digital image was made by exposing the Vatech RVG 1.5 digital sensor. Total 51 patients were included in this study. Clinical and radiographic score of both RVG and IOPA were compared. Result and Conclusion: both radiographs Ultraspeed (D-speed) film and VATECH RVG size 2 super CMOS based digital radiographic sensor significantly underestimated the actual clinical extension of the carious lesions. The mean radiographic differences in estimating the carious depth compared to the true depth were 0.29 mm and 0.42 mm for the VATECH RVG and D-speed film respectively.VATECH RVG images were significantly more accurate than D-speed films in estimating of the carious lesions especially in smaller size lesions.The cavitation percentage increased as the lesion depth increased radiographically and clinically.