Purpose : To compare the diagnostic accuracy of proximal caries detection between Kodak Insight film and the Biomedisys CDX2000HQ digital (CCD) sensor. Materials and Methods: 156 proximal surfaces of extracted teeth, 78 of which had chemical artificial caries, were used in this study. Four observers interpreted the radiographs using a five-point confidence rating scale to record their diagnoses. The results were analyzed by receiver operating characteristic curves, ANOVA and Kappa values. Result: Analysis using receiver operating characteristic curves revealed the areas under each curve which indicated a diagnostic accuracy of 0.951 in Insight and 0.952 in CDX2000HQ digital sensor. ANOVA revealed no significant differences between the two images with respect to caries detection. Kappa values indicated that the mean intra-observer agreement was 0.85 and inter-observer agreement 0.71 in conventional radiography. In digital radiography, the mean intra-observer agreement was 0.84 and inter-observer agreement 0.72. Conclusion: The results suggest that no significant difference exists between the two modalities for artificial caries detection and that CDX2000HQ was as good as Insight film for this purpose.