Background: Pain is a consistent and predominant complaint following surgical intervention including abdominal open hysterectomy. A multimodal approach has been suggested to improve postoperative analgesia and to reduce opioid related side effects. In this context we conducted a comparative study on efficacy between gabapentin and pregabalin on postoperative pain relief.Methods: In this prospective randomised study, 60 patients were divided in to two arms group G and group P. 900 mg of gabapentin and 300 mg of pregabalin were administered orally one hour before spinal anaesthesia to respective groups. Hemodynamic parameters such as heart rate, mean arterial pressure, respiratory rate was monitored pre, per and postoperatively. Also, the need for first analgesic dose and visual analog pain score were documented in all subjects of both groups. Statistical analysis with SPSS 16.0 performed.Results: There was significant fall in mean arterial pressure in group G than group P patients. Further the fall in mean pulse rate was more in group G compared to group P throughout pre, per and post-operative phases. In terms of mean postoperative time required for first dose of analgesic drug, pregabalin and gabapentin was required after 7 and 5 hours respectively. There was a statistically significant change in Visual Analogue Scale, showing pregabalin as better drug than gabapentin in post operative pain control with score 5 and 7 respectively.Conclusions: Pre-emptive analgesia with pregabalin appears to be superior to gabapentin as a part of multimodal perioperative pain management in abdominal hysterectomy.