Background: While parental presence during pediatric dental procedures has been extensively debated, the influence of sibling presence remains largely unexplored. Siblings may provide comfort and assurance to the child through familiarity and modelling, but they can also act as a source of distraction or disrupt clinical setting. This study will help to understand the pediatric dentist’s perspectives on this underexplored aspect which can help develop balanced approaches for managing family involvement in the operatory. Aim: To assess the self-reported attitudes, experiences and clinical observations of pediatric dentists regarding parental and sibling presence in the dental operatory during pediatric dental procedures, using an online questionnaire-based survey. Methodology: The study was conducted as a cross sectional, questionnaire-based survey among 200 licensed pediatric dentists and pediatric dentistry postgraduate residents in Kerala. Participants were invited to complete a structured, self-administered online questionnaire designed to assess their attitudes towards parental and sibling presence during pediatric dental procedures. Responses were collected anonymously and analyzed using descriptive statistics to summarize trends, while inferential statistics will be applied to evaluate associations between demographic/ professional characteristics and attitudes. Results: Among 200 pediatric dental practitioners, parental presence was commonly permitted and largely perceived to enhance child cooperation and communication, particularly during invasive and behavioral management procedures. Sibling presence was more selectively allowed, considered most beneficial for preschool-aged children and during non-invasive care. While many dentists reported occasional negative impacts of family presence, favorable perceptions significantly influenced clinical practice (p < 0.001). Practice setting, but not years of experience, was associated with allowing sibling presence.