INTRODUCTION: Pyogenic granuloma (PG) is a type of reactive hyperplasia that results in the enlargement of soft tissues. Oral PG is traditionally treated by surgical excision with a scalpel in addition to removal of the irritant or trauma source. Surgical removal of a pyogenic granuloma is associated with bleeding and pain. A high rate of recurrence is very common which might be due to incomplete removal. Sclerotherapy would be a good treatment choice for large-sized lesions. OBJECTIVE: To evaluate postoperative pain and recurrence using sclerotherapy versus conventional surgical excision in treating oral pyogenic granuloma. Materials and methods: 20 patients with pyogenic granuloma were enrolled in this randomized controlled clinical trial, divided equally into two groups. Group-I (test group) treated by Ethanolamine Oleate injection as a sclerosing agent. Group-II (control group) treated by surgical excision. Patients were evaluated in terms of pain at the 2nd and 7th day postoperatively and monthly for recurrence up to 6 months. RESULTS:The evaluated parameters demonstrated improvement by the end of the study in comparison to baseline, in terms of postoperative pain. None of the patients in test group reported recurrence at 6 months follow-up. On contrary 2 patients reported recurrence in the control group. However, there was no statistical significance between the two groups. CONCLUSION: Sclerotherapy is simple, inexpensive technique that showed no recurrence for treatment of oral PG.