Introduction: Ulcers pose a significant burden on patients and healthcare systems due to prolonged healing times and the risk of infection. Effective wound management strategies are essential to improve healing outcomes. This study compares the efficacy of nanocrystalline silver (NCS) and cadexomer iodine (CI) dressings in ulcer healing.Methods: A prospective randomized comparative study was conducted at SSIMS Hospital, Davangere, from November 2022 to July 2024, enrolling 45 patients with leg and foot ulcers. Patients were randomly assigned to either the NCS group (n=23) or the CI group (n=22). Wound healing was assessed through parameters such as reduction in wound surface area, granulation tissue formation, and secondary outcomes, including the need for grafting and secondary suturing.Results: The NCS group demonstrated a significantly greater reduction in wound surface area (mean improvement: 33.03 cm² vs. 15.27 cm², p=0.025) and a higher percentage of wound healing (80.64% vs. 56.15%, p<0.001) compared to the CI group. While both groups had comparable Wagner grade distributions, purulent discharge was lower in the NCS group (8.7% vs. 19.0%). Additionally, more patients in the NCS group underwent grafting (30.4% vs. 19.0%), suggesting faster wound healing.Conclusion: Nanocrystalline silver dressings demonstrated superior wound healing outcomes compared to cadexomer iodine dressings. The antimicrobial properties and moisture-retaining characteristics of NCS dressings contributed to enhanced healing. Further large-scale studies and cost-effectiveness analyses are recommended to establish its widespread clinical use.