Abstract Background: pain is a nursing diagnosis and its assessment and management are nurses' primary responsibility. This study aimed to: assess perineal pain after topical application of lidocaine-prilocaine cream and lidocaine infiltration during repair of spontaneous postnatal perineal tears. Patients and methods: this study was conducted at the reception unit at Women's Health Hospital, Assiut University in the period from October 2016 to March 2017. The study sample included 144 women with spontaneous postnatal perineal tear divided in to two groups (72 women in each group); the lidocaine/prilocaine (LP) cream group and the lidocaine infiltration group. The pain score was measured in each group during suturing using the visual analogue scale. Results: the mean pain score was 3.86 ± 1.59 in LP group and 5.99 ± 1.47 for lidocaine group. 76.4% of women in LP group and 30.6% in lidocaine group were satisfied. Conclusions: the findings of this trial concluded that pain is better when using LP cream than using lidocaine infiltration during repair of postnatal spontaneous perineal tears. Recommendations: as the pain is the most common problem in the postnatal period; the study emphasized the importance of postnatal care and good pain management by the nurse.