Pre-emptive analgesia is -blockade of afferent nerve fiber before surgical stimulus. Preemptive analgesia reduces the physiological consequences of nociceptive transmission provoked by the procedure. Pre-emptive analgesia has the potential to be more effective than a similar analgesic treatment initiated after surgery. Consequently, immediate postoperative pain may be reduced and the development of chronic pain may be prevented. Aim of this study was to evaluate the efficacy of preemptive Pregabalin and Paracetamol and comparison between the two. Materials and Methods: 120 patients of ASA class 1 and 2 scheduled for lower limb surgeries under spinal anaesthesia were randomly allocated into two groups of 60 each, Group PG received Pregabalin 150 mg & group PA received 1gm Paracetamol, 1 hour before surgeries respectively, Spinal anaesthesia technique was standardized to all patients. Post operative pain was assessed using VAS at 2, 4, 6, 12, 24 hours after surgery. If VAS more than 3, rescue analgesia was given as Inj. Tramadol 1mg/kg. Time of first rescue analgesic & total amount of analgesic over 24 hours noted. Results: Mean VAS for group PG at 2, 4, 6, 12, and 24 hours after surgery was lower compared to the group PA. Time of first rescue analgesia (4.3±1.2 hrs PG vs 3.3±1.1 Hrs PA) and total number of rescue analgesia for 24 hours period post operatively was significantly lesser for group PG compared to PA. Conclusion: Pre-operative administration of oral Pregabalin 150mg was an effective adjuvant for acute pain after surgery compared to oral Paracetamol 1000mg.