Objective:To determine the effectiveness of prone positioning in patients of covid-19 deisease presented with respiratory failure. Study Design: Retrospective/Observational study Place and Duration: Medicine department of BKMC/MMC, Mardan and Mohiuddin Teaching Hospital, Mirpur AJK for six months during the period from August 2020 to January 2021. Methods: Total 100 patients of respiratory failure admitted to ICU were included in this study. Patients detailed demographics age,sex and body mass index were recorded after taking informed written consent. Patients were aged between 25-80years.Patients were divided in to two groups I and II. Group A had 50 COVID-19 patients underwent prone position and group Bwith50 patients taken as control. Chest X-ray of both groups were taken. Patients of group A were kept in prone position whilegroup B received invasive ventilation and follow up was taken in duration of 15-days. Reduction of intubation rate, mortality, hospital stay and complications were identified among both groups. Complete data was analyzed by SPSS 22.0 version. Results:Majority of the patients was males 76% and the rest were females 24%. Mean age of the patients in prone positioning group was 52.42±13.18 years with mean BMI 26.14±7.13 kg/m2 and in control group A itwas 50.44±14.65 years with mean BMI 26.41±7.13 kg/m2. 55% patients had moderate and 45% had severe covid-19 disease. Mean duration of prone position was 5.14±6.31 hours. Most of the patients 81% had bilateral lung involvementinterstitial infiltrates. Fever, cough and dyspnea were the most common symptom found in both groups. Mean PF ratio was increases in prone group as compared to controlled group. Mean hospital stay in group A was 12.9±4.76 days and in group B mean hospital stay was 17.32±10.24 days. Mortality in group A was 3 (3%) and in group Bmortality was found in 7 (7%). No any severe complications were observed among both groups. Conclusion:We concludedin this study that the use of prone position among patients of COVID-19 was effective and safe method to reduce intubation, mortality and hospital stay. There was no any complication were found after this treatment. Keywords: Prone Position, Covid-19, Respiratory Failure, Mortality