Purpose: To evaluate the effect of cavity preparation method (Er:YAG laser or diamond bur) and bulk-filled composite material type on marginal adaptation mesial occlusal (MO) class II cavities. Materials and Methods: Two-surface box cavities (4-mm proximal depth and 5-mm occlusal width) were prepared on 60 human mandibular molar teeth. Cavities were prepared using Er:YAG laser or diamond burs in an air-turbine hand-piece. All cavities were applied Single Bond Universal dentin bonding agent. The cavities were further subdivided into three subgroups according to the restorative material used; two bulk-filled composites [Filtek Bulk Fill Posterior (3M ESPE) and SonicFill 2 (Kerr)] and one traditional composite material Filtek Ultimate Universal Restorative (3M ESPE). Restorations were evaluated using scanning electron microscopy at x200 magnification for their adaptation to the approximal margins of the tooth. Results were analyzed using the two-way ANOVA and Tukey Post Hoc Test (p<0.05). Results: A total of 900 SEM figures were obtained from all groups. Filtek Bulk Fill Posterior, SonicFill 2, and Filtek Ultimate Universal Restorative exhibited statistically similar gapped margins. However, the lowest scores of gapped margins were observed with SonicFill 2 (4.22%). Conclusions: Completely gap-free margins were not obtained with any of the tested materials. Bulk-fill composite materials showed similar marginal adapatation compared with standard composite. Marginal adaptation of Er:YAG laser prepared cavities was more irregular and had more gaps, but was statistically similar to diamond bur-prepared cavities.