Parental perception of child cooperation during dental examination and acceptance of behavior guidance techniques are critical determinants in the successful provision of pediatric dental care, particularly for children with autism spectrum disorder, who frequently exhibit behavioral and communication challenges. This cross-sectional comparative study aimed to evaluate differences in parental perception and acceptance of behavior guidance techniques between autistic and non-autistic children in Benghazi City, Libya. The study was conducted over a four-month period in the Rehabilitation Centers for children with autism spectrum disorder and the Medical Services Center. A total of 60 children aged 3-14 years were enrolled, including 30 autistic children and 30 non-autistic healthy control children. Data were collected through structured self-administered questionnaires completed by parents or caregivers during personal interviews. The questionnaire gathered information on socio-demographics, parental education and occupation, prediction of child cooperation during dental examinations, and acceptance of behavioral guidance techniques. The statistical analysis was performed by Chi-square, Fisher’s exact, and Monte Carlo tests where appropriate. The results revealed no significant differences between the groups in terms of age-related differences, gender distribution, or parental educational level. However, a significant difference was observed in parental perception of child cooperation. The majority of parents of non-autistic children (80.0%) anticipated cooperative behavior, whereas most parents of autistic children were uncertain (73.3%) or expected uncooperative behavior (10.0%). Sedation was the most accepted technique among parents of autistic children (66.7%), followed by general anesthesia (20.0%), while Tell-Show-Do was predominantly accepted among parents of non-autistic children (93.3%). Restraint techniques were accepted minimally in both groups. Parents of children with autism demonstrated greater acceptance of advanced pharmacological approaches, highlighting the need for individualized communication and tailored behavior management strategies in pediatric dental practice.