Objectives: To compare the efficacy of epidural and I/V Tramadol for painless labor and effect on perinatal outcome. Material and methods: A total of 90 parturients admitted in S.N. Medical College, Agra were selected for study. Thirty parturients received intravenous tramadol, thirty received epidural tramadol and thirty were kept as controls by the method of randomization. In the intravenous group, tramadol in doses of 1mg/Kg body weight IV bolus and 100mg in 500ml Ringer lactate at the rate of 8-24 drops/min was given. In the epidural group tramadol 1mg/kg body weight with 8-10 ml of 0.25% bupivacaine was given. Results: In the epidural group, pain relief was excellent in 36.67%, good in 50% and average in 13.33%. In intravenous group, pain relief was excellent in 10%, good in 26.67% and average in 63.33%. In both the groups there was no significant effect on duration of 1st & 3rd stage of labor. Second stage of labor was prolonged in the control group. There were no significant changes in APGAR scoring. Conclusion: Epidural tramadol is a safe and effective method for labor pain relief better than I/V tramadol.