Background: Emergency contraception (EC) is a method to be used in the case of unprotected sexual intercourse, failure of a regular contraceptive method and after rape to try to prevent an unintended pregnancy. They include copper intrauterine devices (IUD) and different types of pills like estrogen-progestin combination pill, levonorgestrel containing pills (LNG). Objective: This study was conducted to compare the efficacy; satisfaction, pregnancy rate and side effect of emergency contraception in women who selected either oral levonorgestrel (LNG) or copper intrauterine device (IUD). Patient and methods: This observational prospective cohort study was conducted on 200 women enrolled and separated into two groups, IUD group: 100 women used cupper T380A IUD. LNG group: 100 women using levonorgestrel 1.5 mg divided into two doses each 0.75 mg 12 hours a part. Satisfaction was assessed using a 5-point Likert scale. Results: There was significantly higher rate of contraption efficacy in IUD group compared with LNG group (p < 0.05). Significantly higher rates of nausea, vomiting and headache in LNG group (p < 0.05) when compared with IUD group. IUD patients had significantly higher rate of bleeding (p < 0.05) and higher rate of satisfaction among LNG users (p < 0.05). Significant association between women satisfaction and efficacy in LNG group (p < 0.05) and significant association between women satisfaction and efficacy in IUD group (p < 0.05). Conclusion: Emergency IUD has higher efficacy than emergency contraceptive pills (LNG) and has fewer side effects. However, there is more satisfaction regarding emergency contraceptive pills (ECP) as compared to IUD.