OBJECTIVES: The study was designed to compare two analgesic regimens administered after cesarean delivery in a routine hospital setting with respect to patients' perceptions of their pain relief and the impact of analgesic technique on hospital costs. METHODS: This study was undertaken based on our previous paper that evaluated postoperative pain in a double-blinded, randomized, single-dose comparison of the monoaminergic and µ-opioid agonist tramadol, 100 mg (Group T) and piroxicam 20 mg (Group P) given IM alone- single dose in 150 patients who had elective cesarean delivery. All patients were assessed at 0, 6, 12 and 24 hours post operation for pain degree (by Visual Analogue Score: VAS 1-10), nausea and vomiting. Our outcomes were the power of drug to reduce pain and our costs came from drug prices. Incremental Cost-Effectiveness Ratio (ICER) was calculated. RESULTS: There was no significant difference between the efficacy of tramadol and piroxicam injections (P>0.05). Side effects were similarly minimal with all treatments. Total costs in P group were $16.33 and in T group were $47.52. CONCLUSIONS: In this study, ICER showed that analgesic effect of piroxicam is more cost-effective than tramadol.