Background: Intra uterine contraception methods are long-acting reversible contraceptives (LARC) with licensed durations of use ranging between 3 and 10 years. Fear of pain at placing can be an obstacle to IUD selection leading to women's counseling on other, less effective methods. Objective: To evaluate the use of US-guided IUD insertion for increasing patient satisfaction and minimizing the pain and duration of the procedure and compared with the IUD traditional insertion method. Patients and Methods: A randomized, comparative, trial was performed on  200 women scheduled to undergo IUD insertion at the outpatient clinics of Obstetrics and Gynecology Department of Sinbillawin General Hospital from(1st of April2020 till30thDecember2020) .Women received Copper T380A(pregna) by withdrawal technique and Mirena IUD insertion. Patients were classified into two equal groups: Group (A): were scheduled for trans abdominal ultrasound-guided IUD insertion; and Group (B): were scheduled for Non Guided method of IUD insertion. Results: Patient's pain during IUD insertion in Group (A) was statistically significantly lower than group (B) (P<0.001). Patient's duration of the IUD insertion procedure (seconds) in Group (A) was statistically significantly lower than group (B) (P<0.001). Patient's failed insertion in Group (A) show that 3% of the women had failed insertion and 96% of them had IUD insertion in place, while in Group B, 6% of the women had failed insertion, 80% of the women had IUD insertion in place, and 14% had IUD insertion misplaced. There were statistically significant differences between groups (p < 0.001). There was high statistically significant differences between groups as regard to patient's satisfaction (P<0.001). Conclusion: US technique insertion is more effective, less painful and more client satisfaction.