Abstract: The objective of this study was to compare the efficiency of lidocaine with that of plain saline for paracervical pain relief during fractional curettage. The double-blind randomized clinical trial was performed on 150 patients presenting from 2004 to 2005 for curettage. The patients were assigned randomly in two groups to receive lidocaine 1% or normal saline. Number of patients at each group was 75 women. The pain intensity was assessed in four stages: 1) after speculum insertion, 2) during cervical dilatation, 3) during curettage and 4) 30 min after curettage completion. The pain intensity was graded as 0 to 100 according to the Likert Scale. The Mean±SD of pain intensity after speculum insertion, during dilatation, during curettage and 30 min after curettage in lidocaine group were 11.33±9.70, 24.93±15.36, 37.00±17.35, 6.47±6.42 and in normal saline group were 11.73±9.81, 28.20±13.19, 49.47±21.55 and 7.33±6.22, respectively. There was no significant difference between pain intensity after speculum insertion, during dilatation and during 30 min after curettage but there was a significant difference in pain intensity during curettage between lidocaine 1% group and normal saline group (p<0.05). Normal saline is as effective as lidocaine 1% in low pain in curettage (distention of nerve capsule) but when increase pain in curettage (third time point), lidocaine 1% is more effective than normal saline. Nerve capsule distention is not the only factor for pain control in paracervical block and analgesic agent is still an important factor.