Background: Dysmenorrhea is one of the most common acute paindisorders among women of reproductive age.Aims: To compare the effects of IV paracetamol with dexketoprofenin patients presenting with primary dysmenorrhea to the emergencydepartment.Study Design: Randomized controlled trial.Methods: Patients over 18 years old presenting with pelvic painrelated to menstruation were eligible for the study. Study patientsreceived 1 g paracetamol or 50 mg dexketoprofen in 100 mL normalsaline with a 4-5 minute infusion via the intravenous route. Painintensity was measured by a visual analog scale at 15 and 30 minutes.Patients were randomized and assigned to either of two study armsvia sealed envelopes. Study drugs were identical in color, and thusboth personnel and patients were blinded to the study drug. Thedexketoprofen group comprised 49 patients, and the paracetamolgroup had 50 patients in the final analysis.Results: The mean age of the study subjects was 20.9±2.5 and themean duration of the pain was 1.9±1.7 (median: 1, interquartile range:1 to 2) hours. Both dexketoprofen (median change: 33, 95% CI:24 to 38) and paracetamol (median change: 21, 95% CI: 12 to 32)effectively reduced the pain at 15 minutes, which was repeated at 30minutes (median change: 63, 95% CI: 57 to 65 vs 55.5, 95% CI: 50 to59, respectively). Pain improvement in the dexketoprofen group wasbetter than in the paracetamol group at 15 (median difference: 8, 95%CI: 0 to 16, p=0.048) and 30 (median difference: 6, 95% CI: 1 to 12,p=0.028) minutes, which was statistically significant but not clinicallysignificant.Conclusion: Dexketotoprofen has a better visual analogue scale scorethat is not clinically relevant compared to paracetamol.