Abstract Background: Acute postoperative pain and side effects can be serious problems, due to either insufficient or excessive treatment. If analgesic treatment is begun after a painful stimulus, treating postoperative pain can be challenging because of the possibility of peripheral hypersensitivity and central nervous system hyperexcitability. Pre-emptive analgesia focuses on reducing postoperative opioid consumption and pain levels, decreasing the incidence of adverse events and improving patient satisfaction. Several pre-emptive analgesic regimens have been tried in the perioperative period, including opioids, nonsteroidal anti-inflammatory drugs, and so on. Aim of Study: To evaluate the effects of oral pregabalin, before abdominal surgery, on postoperative pain intensity and analgesic requirements (primary outcome), and the incidence of post-operative nausea and vomiting (secondary outcome). Patients and Methods: This randomized controlled trial was conducted on 60 adult healthy patients aged 21-50 years of both sex, ASA physical status I and II undergoing elective abdominal surgery (open or laparoscopic). Patients were equally randomized to: Group A: Received pregabalin 300mg/12hrs 24 hrs before surgery. Group B: Did not receive pregabalin. Results: Time of first analgesic requirement was signifi-cantly delayed in group A compared to group B (p-value <0.001). Total pethidine consumption was significantly lower in group A compared to group B (p-value <0.001). Incidence of PONV was 5 (16.67%) patients in group A and 13 (43.33%) in group B. Incidence of dizziness was 20 (66.67%) patients in group A and 4 (13.33%) in group B. Incidence of PONV was significantly lower in group A compared to group B (p -value=0.024). Incidence of dizziness was significantly higher in group A compared to group B (p-value <0.001). Respiratory depression and hypotension were insignificantly different between both groups. Conclusion: Preoperative administration of 300mg/12hrs 24hrs of pregabalin resulted in a significant reduction pain score, intraoperative fentanyl consumption, total pethidine consumption and incidence of PONV following elective abdominal surgery but with higher incidence of dizziness.