Background: Management of acute pain after cesarean section has evolved considerably over the past decade. The general approach to pain after cesarean section is changing, shifting away from traditional opioid-based therapy. Typical analgesic regimens include opioids and nono-pioid analgesics, such as paracetamol and NSAIDs, with the variable addition of local anesthetic techniques. Aim of the Work: The aim of this study is to compare the efficacy of intravenous infusion of paracetamol in comparison with meperidine (pethidine) as post cesarean section analgesia, as demonstrated by the degree of pain relief. Patients and Methods: This terventional prospective randomized study was conducted at El- Helal Hospital for Health Insurance, Damitta. It comprised (90) labouring women who seek post C.S analgesia. They were divided into two groups: 1st group (group A, 45 women): They received 100 ml intravenous perfalgan containing 1000 mg paracetamol. Second group (group B, 45 women): They received 50 mg meperidine hydrochloride Intramuscular. Results: There was a statistically significant lower pulse rate in the pethidine group 84.3 ± 5.18 as compared to paracetamol group 87.3 ± 6.85 (p=0.024). While systolic and diastolic Blood pressure showed non-significant difference between the two groups. The mean visual analogue scale (VAS) after 1hour of receiving analgesia in the paracetamol group was 2.19 ± 0.79 while in the pethidine group it was 2.09 ± 0.72 and this was statistically significant (p=0.039*). As regards side effects, in the pethedine group, 3 (6.7%) patients had nausea and vomiting, 2 (4.4%) patients had hypotension and 1 (2.2%) patient had a decreased respiratory rate, While, no side effects noticed in the paracetamol group. This difference was statistically highly significant (p=0.037*). Conclusion: Paracetamol is as effective as pethidine in relieving pain after cesarean section. Prescribing paracetamol in the form of intravenous infusion can be suggested as a suitable alternative for opioid after the operation. No side effects were noticed in patients who received paracetamol making it highly safe. Recommendations: Further studies on a larger scale of patients are needed to confirm the results obtained by this study.