Background:Anal fissure is a common problem that causes substantial morbidity in who are otherwise healthy. The present study was conducted to compare the effect of zinc oxide cream and lidocaine ointment in acute anal fissures. Materials & Methods:118 patients with acute anal fissures of both genderswere divided into 2 groups of 59. Group I patients weregiven 15% of zinc oxide cream twice a day and group II patients weregiven 5% of lidocaine ointment twice a day. Healing rates, pain relief, recurrences, changes in symptoms after the treatment, and complications were recorded. Results: In group I, males were 39 and females were 20 and in group II, males were 32 and females were 27. Common clinical features were bleeding per rectum in 42 and 53, constipation in 37 and 41, pain in 12 and 28 and discharge in 25 and 34 in group I and II respectively. The difference was significant (P< 0.05). In group I and group II, bleeding per rectum was present in 19and in 5 patients and absent in 40 and 54 patients respectively. Constipation was present in 13 and 6 and absent in 46 and 53, pain was present in 17 and 10 and absent in 42 and 49, discharge was present in 6 and 1 and absent in 53 and 58, fissure healing was present in 23 and 15 and absent in 36 and 44 patients respectively. The difference was significant (P< 0.05). Conclusion: Lidocaine ointment in acute anal fissures were found to be better than zinc oxide cream. Hence, conservative management is better treatment option for acute fissure-in-ano.