Abstract Background: Almost 50 percent of primiparous women suffer from acute perineal pain after episiotomy; Ketoprofen phonophoresis is effective in decrease acute perineal pain after episiotomy. Aim of Study: This study was conducted to determine the effect of ketoprofen phonophoresis on acute perineal pain after episiotomy. Patients and Methods: Forty primiparous women suffer-ing from acute perineal pain after episiotomy were participated in this study. They were selected randomly from the maternity ward at Dar – Ismaeil Hospital For Obstetrics & Gynecology in Alexandria. Their ages were ranged from (20-30) years old; their body mass index didn't exceed 30kg/m2, and their pariety was (zero) children. They were divided randomly into two equal groups as study group (Group A) and control group (Group B). The study group (Group A) was consisted of 20 patients. Each patient in this group received ketoprofen phonophoresis around stitches of episiotomy for 10 minutes, twice daily for 7 days. Also, each patient was asked to perform pelvic floor exercises for 20 minutes, twice daily for 7 days. While, control group (Group B) was consisted of 20 patients. Each patient in this group was asked to perform pelvic floor exercises for 20 min-utes, twice daily for 7 days as in group (A). All patients in both groups (A&B) were evaluated by Visual Analogue Scale (VAS) and measuring serum cortisol level in blood plasma before starting and after the end of treatment program. Results: Both groups (A&B) showed a statistically (p<0.001) significant decrease in visual analogue scale (VAS) and serum cortisol level after the treatment course, yet this de-crease in VAS and serum cortisol level in blood plasma was more pronounced and statistically significant (p<0.001) in study group (Group A) when compared to control group (Group B). Conclusion: Ketoprofen phonophoresis is an effective method for treating acute perineal pain after episiotomy.