Premature ejaculation (PE) is the most common sexual dysfunction with many lines of treatment. Paroxetine and Tramadol were reported in to be effective in treatment of PE. Aim is to investigate the efficacy of Tramdol 50mg versus paroxetine 20mg in treatment of PE. Fifty patients enrolled out in this study they have been advised to use each drug for three weeks with at least ten successive intercourse three to four hours prior to intercourse. Conclusion our finding support that tramadol 50mg on-demand offers better effect than paroxetine 20mg on-demand in treatment of premature ejaculation.