Background: Inadequately controlled postoperative pain causes discomfort, increased use of medications, slower recovery, longer hospital stay and increased risk of pulmonary complications [5]. Postoperative analgesia with safer drugs and minimal side effects is the first choice. This study was undertaken to evaluate the role of Inj. Paracetamol vs. Inj. Tramadol in post-operative pain relief after head and neck cancer surgeries. Material & Method: After IRB approval and informed consent, this prospective, randomized study was conducted in 100 patients (ASA I & II) with age group of 18-60 years undergoing elective head and neck cancer surgery. Patients were divided into two groups. A) Group P: Inj. Paracetamol 15 mg/kg IV over 15 min, 30 min prior to the end of surgery and subsequent doses at 6 hours interval 24 hours. B) Group T: Inj. Tramadol 1 mg/kg diluted in 10 ml saline IV slowly over 10 min, 30 min prior to end of surgery and subsequent doses at 8 hours interval for 24 hours. Results: Postoperative VAS decreased at various time intervals in both groups. Time to 1st dose of rescue analgesia requirement was lower in Group T, with mean postoperative rescue analgesic free time interval of 6.23±1.72 hours as compared to Group P where it is 5.01±1.16 hours. Frequency of rescue analgesic requirement was lower in Group T, with mean of 1.20 (±0.41), in comparison to Group P 1.67 (±0.71). Postoperative nausea, vomiting is more in group Tas compared to group P. Conclusion: Intravenous paracetamol administration in peri-operative period provided adequate postoperative analgesia with fewer side effects in patients undergoing head and neck cancer surgery. Intraoperative IV paracetamol appears to be a reasonable choice for postoperative analgesia in this patient population.