BACKGROUND Temporomandibular joint(TMJ)is the third most common site of pain in the orofacial area, while the masseter muscle was the primary painful masticatory muscle. The temporal and frontal region were pain areas indicated by temporomandibular joint disorder (TMDs) patients. The purpose of this study was to compare two different treatment modalities, physical therapy and occlusal appliance to treat myofascial pain. METHODS This retrospective study comprises of all orofacial pain patients attending orofacial pain clinics of Dental University Hospital, King Saud University in Riyadh, Saudi Arabia. Patients were categorized into two groups, the first group: patients treated by the occlusal appliance (hard type). The second group: patients treated by physiotherapy home exercises, including posture position modification. Physical therapy included muscle stretching and isometric tension against resistance exercises and guided jaw movements. Methods of clinical examination was based on the research diagnostic criteria for temporomandibular disorders (RDC/TMD) criteria. The data of pain level was collected based on the visual analog scale (VAS). RESULTS 16.1 % of patients were male, and 83.9 % of the patients were female. With the mean age being 31.1 years old. 92.9 % were Saudi patients and 7.1 % were non-Saudi. 50 % of the patients were using an occlusal appliance, and 50 % went for physiotherapy. The independent t-test showed a highly significant difference between different management methods with a P – value of 0.038 and a mean difference of 0.32143. 80.5 % of the patients reported masseter muscle pain as one of their main complaints. CONCLUSIONS A significant difference was observed between physiotherapy and occlusal appliances with education in treating patients with myofascial pain. Patients using the occlusal appliances showed a high percentage of pain reduction (85.7 %) compared to physiotherapy treatment (57.1 %) in a short period of time. Henceforth, patient’s education plays a significant role in pain reduction. KEY WORDS Temporomandibular Joint Disorder, Occlusal Appliance, Myofascial Pain, Physiotherapy