Objective: Aim of this study was to compare the double (DAP) and triple (TAP)antibiotic paste removal efficiency of conventional syringe irrigation (CSI),EndoActivator (EA), passive ultrasonic irrigation (PUI) and XP-endo finisher (XPF)from simulated immature root canals.Materials and Methods: A total of 180 extracted mandibular canine roots wereused. The apical 2 mm of the roots were removed, and Unicore drills were penetratedthrough the apical to the coronal direction approximately 1 mm to simulate animmature apex. Canals were prepared up to size 40 by using the Mtwo system.Roots were split longitudinally and then temporarily reassembled. The sampleswere randomly divided into 2 main groups as DAP and TAP. Five specimens foreach main group were kept as negative control group. Then the pastes were placedwith lentulo spiral. After 1 week five specimens for each main group were kept aspositive control group. Then the remaining specimens in DAP and TAP groups werefurther assigned to 4 subgroups according to the removal technique (group 1: CSI;group 2: EA; group 3: PUI, group 4: XPF). The root halves were examined undera stereomicroscope at 10x magnification. Kruskal-Wallis H and Mann-Whitney Utests were used for statistical analyses.Results: TAP and DAP were more effectively removed by XPF and PUI compared toCSI and EA (p<0.05). XPF and PUI DAP/TAP removal effectiveness was statisticallysimilar (p>0.05). Moreover, CSI and EA showed similar effectiveness for both pastegroups (p>0.05). Regarding the type of antibiotic paste, no significant differencebetween TAP and DAP was found (p>0.05).Conclusion: The tested irrigation systems could not completely remove either TAPor DAP. The use of PUI or the XPF was more effective compared to the use of theEA and CSI.