Background: Allergic rhinitis (AR) is a prevalent condition characterized by inflammation of the nasal mucosa, leading to bothersome symptoms. This study aimed to compare the efficacy of two treatment regimens, namely oral Levocetirizine with Montelukast and Fluticasone Furoate nasal spray versus oral Levocetirizine with Montelukast alone, in managing AR symptoms. Method: A prospective, comparative study, was conducted at the Department of Otorhinolaryngology, SRM Medical College Hospital and Research Centre, involving 240 AR patients from July 2016 to September 2017 with the follow up of 6 weeks for each patient. Patients were randomized into two groups: Group A received Montelukast tablets, Levocetirizine, and Fluticasone Furoate nasal spray, while Group B received Montelukast tablets and Levocetirizine. The efficacy was assessed using the Total Nasal Symptom Score (TNSS) scale, and absolute eosinophil count was evaluated. Outcome of the study: Patients receiving Oral Levocetirizine with Montelukast and Fluticasone Furoate Nasal Spray demonstrated superior outcomes compared to those receiving Oral Levocetirizine with Montelukast alone. They exhibited higher reductions in obstruction and itching scores during the second visit, along with a moderate increase in total score. Additionally, patients in this group showed a significant reduction in absolute eosinophil count during the last visit. Conclusion: The combination therapy of Oral Levocetirizine with Montelukast and Fluticasone Furoate Nasal Spray proved to be more effective in alleviating nasal obstruction and itching symptoms, reducing total symptom burden, and managing AR more effectively compared to Levocetirizine with Montelukast alone.