Monte Carlo (MC) simulation is a simpler radiation dose assessment method than the conventional method, thermoluminescent dosimetry (TLD). MC simulation and TLD were compared as tools to evaluate the effective dose from paediatric panoramic radiography. Various exposure conditions and machine geometries were simulated using the MC method to investigate factors resulting in effective dose reduction. The effective dose of paediatric panoramic radiography was obtained using an MC simulation and its reliability was verified by a comparison with the value obtained using TLD. Next, 7 factors determining the effective dose in the MC simulation were input with 6 equally-spaced values, and a total of 36 simulations were performed to obtain effective dose values. The correlations between each dose-determining factor and the resulting effective dose were evaluated using linear regression analysis. The TLD-measured dose was 3.850 µSv, while the MC simulation yielded a dose of 3.474 µSv. Beam height was the factor that most strongly influenced the effective dose, while rotation angle and focus-to-patient distance were the least influential factors. MC simulation is comparable to TLD for obtaining effective dose values in paediatric panoramic radiography. Obtaining panoramic radiography with a short beam height can effectively reduce the dose in paediatric patients.