BACKGROUND: Circumcision has been practiced since antiquity and it is still one of the most commonly performed surgical procedures. Over the centuries, numerous techniques for circumcision have been developed. The two most popular techniques in this environment are the freehand and Plastibell techniques. The aim of the study was to compare the efficacy and safety of freehand and Plastibell techniques of circumcision. PATIENTS AND METHODS: The study was a prospective longitudinal interventional study that was conducted on uncircumcised males at or below the age of 5 years that presented for circumcision. The study was conducted at Ahmadu Bello University Teaching Hospital, Zaria. The patients were thoroughly evaluated. All boys who satisfied the inclusion criteria and whose parents or those whose loco parentis consented were randomized into two groups. Group A had freehand circumcision while Group B had Plastibell circumcision. All the surgeries were performed by the investigator. The patients were seen at day 7 and day 28. The variables compared were operating time, complications and parents` satisfaction. All the data obtained were entered into a proforma. The data obtained were analysed using SPSS version 20 RESULTS: A total of 110 boys were circumcised by the investigator, 55 boys in each group. The median ages in the Plastibell and freehand groups were 1 and 3 months respectively. The mean operating time was shorter in the Plastibell group compared to freehand (3.53 minutes versus 16.7 minutes). This was found to be statistically significant. The complications were more in the Plastibell group compared to freehand (29.1% versus 9.1%; P = 0.008). The complications in Plastibell group were age related. There were no cosmetic concerns in both groups. CONCLUSION: Plastibell circumcision is faster than freehand. This is quite important in high volume centers. The outcome of Plastibell is best is infants. Freehand circumcision is safe for all age groups, but it is recommended for older children.