Background: The intrauterine contraceptive device (IUCD), which is a plastic T-shaped device with copper attached to it, is the most widely used type of reversible contraception in the world. It was developed more than 30 years ago and has since become the industry standard due to its long-term effectiveness, safety, and affordability. Objective: To compare the effectiveness of oral ibuprofen versus 10% lidocaine spray as pain killers during the installation of copper intrauterine devices. Patients and Methods: This prospective, randomized clinical study comprised 140 women who sought out the Family Planning Clinic at Ain Shams Maternity Hospital between December 2021 and June 2022 in order to have an IUCD inserted for the purposes of contraception. Two groups were created from the participants. Those in Group 1 were given four sprays (40 mg) of 10% lidocaine spray to be administered topically on the cervix uteri 3-5 minutes before to IUCD implantation, whereas those in Group 2 were given 400 mg of ibuprofen tablets orally to be taken at least 45 minutes before IUCD implantation. Results: Failure of insertion statistically was non-significantly different among lidocaine spray and ibuprofen tablet groups. Vasovagal reactions statistically were non-significantly less frequent among lidocaine spray. Patients' pain perception statistically was significantly lower among lidocaine spray group. Moderate pain statistically was significantly less frequent among lidocaine spray. Need to analgesics statistically was significantly less frequent among lidocaine spray. Conclusion: Pain from IUCD insertion may be effectively managed with 10% local lidocaine spray, which is more convenient than ibuprofen pills and takes action quickly. When deciding between ibuprofen pills and lidocaine spray for pain management following IUCD implantation, many women choose the latter.