Aim: Evaluate the patient satisfaction of monolithic zirconia crowns with vertical preparation technique and compare them to deep chamfer finish line preparation in single crowns restoring posterior teeth. Materials and methods: Fourty full coverage zirconia crowns were fabricated for posterior teeth. The patients were divided into two groups according to the preparation designs. Group1: (control group) horizontal finish line and Group2: (intervention group) vertical finish line. Monolithic zirconia was used for the final restorations. EXOCAD software was used to design the try-in & final restorations which were later produced by five axis milling machine. The cementation was done by using self-adhesive resin cement. Patient satisfaction was assessed immediately after cementation using the “Visual Analogue Scale” VAS. These measurements were repeated after one, three, six, nine, and twelve months respectively. Result: independent t-test was used to compare between the two groups. No statistically significant difference was detected between both groups for patient satisfaction over one year. Conclusion: Both horizontal finish line and vertical finish line revealed successful clinical performance in terms of patient satisfaction for zirconia full coverage restorations.