Background: The most prevalent type of neuralgia is trigeminal neuralgia (TN). Other names for it include tic-douloureux, Fothergill's illness, and tri facial neuralgia. The present study compared carbamazepine and combination of carbamazepine with baclofen in the management of trigeminal neuralgia. Materials & Methods: 72 patients of trigeminal neuralgia of both genders were divided into 2 groups. Each group had 36 patients. Group I patients received 600–800 mg/day carbamazepine twice daily and group II received 600 mg/day carbamazepine plus baclofen 10–20 mg/day twice daily. Patients were recalled after 7 days, 15 days and 30 days. Results: Group I had 14 males and 22 females and group II had 15 males and 21 females. The mean pain score on VAS at baseline was 9.6 in group I and 9.4 in group II, at 7 days was 6.2 in group I and 5.1 in group II, at 15 days was 5.1 in group and 3.7 in group II and at 1 month was 3.4 in group I and 1.5 in group II. The difference was significant (P< 0.05). Conclusion: In patients with trigeminal neuralgia, carbamazepine plus baclofen reduces pain more effectively than carbamazepine alone.