Background: Intrauterine contraceptive device (IUCD) is one of the most common contraception methods. In a survey of female Fellows of the American College of Obstetricians and Gynecologists, the prevalence of personal IUCD use was >20-fold higher than among women in the general population. In statistical terms, The IUCD is used by approximately 15% of reproductive-aged women in developing countries and 8% in developed countries. Aim of work: To compare the safety and efficacy of different local lidocaine preparations (spray, cream and injection) for reducing pain associated with IUCD insertion. Patients and Methods: This is a prospective randomized clinical trial. The study was conducted at Ain Shams University Maternity hospital at family planning outpatient clinic during the period between December 2017 and June 2018. Results: Results proved that lidocaine 10% spray application to the cervix during IUCD insertion effectively reduce pain felt during stages of IUCD insertion and is good option for reduction of pain associated with IUCD insertion in compared with lidocaine injection or cream. Conclusion: Our study demonstrated that local lidocaine spray 10% is effective in control of pain associated with IUCD insertion when compared with lidocaine cream or injection because its application is easy and rapid, while lidocaine injection can also reduce pain but injection itself is painful that makes it unfavorable method.