Sago pearls and tapioca pearls are not the same. Sago pearls are made from the sago palms (sago palm trees) and are widely used in Asian desserts in the Southeast Asia region. They vary in sizes and each pearl appear as small white ball before cooking. Once cooked, they become translucent and chewy. This sago pudding is best made with the small sago pearls. You can find sago in your local Asian grocer stores. Tapioca pearls, on the other hand, are made from the tapioca starch, a root vegetable (also called cassava root). These are often used in milk tea drinks. Tapioca pearls can come in small sizes like sago but these small tapioca pearls are not suitable for this sago pudding. In some parts of the world, tapioca pearls are also called sago.