A precise impression is necessary for fabricating an accurately fitting cast restoration. For this purpose, Polyvinyl Siloxane (PVS) impression materials are extremely popular because of their combination of excellent physical properties, handling characteristics and dimensional stability. Its excellent clinical features remain unaffected if simple measures are guarded. This review presents several impression techniques using PVS and recommends the one that provides the most accurate impression, utilizing the superior qualities of the PVS. The one step impression technique where no control of wash bulk and thickness exists, is considered to be the least accurate impression method with measured discrepancies as large as 7 times the original inter preparation distance and 40 times the original cross arch dimensions. Furthermore, the direct contact between the less refined putty material and the tooth preparation, as well as the high prevalence of air bubble entrapment, seriously compromises restoration longevity. The two stage impression technique has proved to produce the most accurate and reliable impressions due to complete control of the wash bulk and thickness entailed. The ideal wash bulk thickness should range between 1 to 2.5 mm all around the abutment tooth in order to minimize distortion of its subsequent die. Using a "Putty Tray" at the first stage with a predetermined space encircling the abutments will allow the wash to flow to its ideal uniform bulk size at the second stage. A uniform bulk size will prevent differential setting contraction and uneven changes at the dimensions of the die. The easiest and most clinically applicable method to achieve the desired space around the preparations is by loading the Putty material with the temporary crowns in place, followed by their removal at the second stage and occupation of the created space by the wash. In general, less control of wash bulk will result in either insufficient or excessive wash material which will determine uneven dimensional changes in the impression. This, in turn, will produce ill fitting cast restoration.